Active NPI
Alexa Martin, D.M.D.
- Dentist
- Long Beach, CA
National Provider Identifier
1790132405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS100087
- Practice address
- 141-P E. Willow St.
Long Beach, CA 90806-2634 - Phone
- (563) 988-2888
- NPI assigned
- May 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS100087 | CA | Primary |
| Dentist | 122300000X | DE60640137 | WA |
Addresses
Primary practice location
141-P E. Willow St.
Long Beach, CA 90806-2634
Mailing address
141-P E. Willow St.
Long Beach, CA 90806-2634
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS100087 | CA | MD | Dentist |
| DE60640137 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463961600000",
"number": "1790132405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141-P E. WILLOW ST.",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141-P E. WILLOW ST.",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062634",
"telephone_number": "563-988-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ALEXA",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-23",
"last_updated": "2016-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS100087",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60640137",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.