Walnut Avenue Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WALNUT AVENUE DENTISTRY

Practice address

305 Walnut Ave
San Diego, CA 92103-4904

Phone

(619) 291-1181

NPI assigned

Feb 20, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christie Lynn Martinez, DDS

Title

Owner

Phone

(619) 291-1181

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kriston Gallipeau

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1821125410
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519084800000",
    "number": "1801396403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034904",
            "telephone_number": "619-291-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034904",
            "telephone_number": "619-291-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT AVENUE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-291-1181",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walmart Stores, Inc.
• Walmart, Inc.
• Walmart, Inc.
• Walmart, Inc.
• Roxy Rae Walnum, M.A., R.A.S.
• Lynne Walrath
• Emily Eve Walsdorf
• Seth David Walsh-Blackmore, MD
• Nathan Lamar Walsh-Haines
• Alicia Walsh, M.S., LMFT

• Dental Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.