Martin Sobieraj, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7393 Issued in AZ

Practice address

815 E Juan Sanchez Blvd
San Luis, AZ 85349-2017

Phone

(928) 627-8584

Fax

(928) 627-8949

NPI assigned

Jul 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1851591705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E THOMAS RD",
            "address_2": "STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167675",
            "telephone_number": "928-539-3082",
            "fax_number": "928-539-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E JUAN SANCHEZ BLVD",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853492017",
            "telephone_number": "928-627-8584",
            "fax_number": "928-627-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBIERAJ",
        "first_name": "MARTIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6664867-9921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerardo Ochoa Sanchez, PA
• Santa Teresa Pharmacy II LLC
• Santa Teresa Pharmacy LLC
• Mandana Semnani, MD
• Shruti Sharma, MD
• Sonortica Dent All Group, LLC
• Marisol Soto Jimenez, DDS
• South County Diagnostic Services, LLC
• South County Diagnostic Services, LLC
• South County Diagnostic Services, LLC

• General Practice Dentistry in San Luis, AZ
• Providers in San Luis, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.