Individual provider Active NPI

Martha Beatriz Martinolich, DMD

  • Dentist
  • Marlton, NJ
National Provider Identifier
1851075154
Registry record updated Mar 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02979700 Issued in NJ
Practice address
320 Evesboro Medford Rd Ste 101
Marlton, NJ 08053-5733
Phone
(856) 334-6010
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02979700 NJ Primary

Addresses

Primary practice location

320 Evesboro Medford Rd Ste 101
Marlton, NJ 08053-5733

Mailing address

521 S Broad St Apt 707
Philadelphia, PA 19147-1064
Phone (786) 665-0758

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22DI02979700NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marlton LV Dental LLC CurrentSince Aug 27, 2023 Accepting new patients

Locations

320 Evesboro Medford Rd
Ste 101
Marlton, NJ 08053
Phone (856) 334-6010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709337600000",
    "number": "1851075154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S BROAD ST APT 707",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471064",
            "telephone_number": "786-665-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EVESBORO MEDFORD RD STE 101",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080535733",
            "telephone_number": "856-334-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINOLICH",
        "first_name": "MARTHA",
        "middle_name": "BEATRIZ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02979700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2024; 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.