Individual provider Active NPI

Alexandra Trinidad Quiroz Martin, DMD

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1881180669
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D010288 Issued in AZ
Practice address
5445 N Kolb Rd Ste 205
Tucson, AZ 85750-0750
Phone
(520) 577-7667
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10828 OR
General Practice Dentistry 1223G0001X D010288 AZ Primary

Addresses

Primary practice location

5445 N Kolb Rd Ste 205
Tucson, AZ 85750-0750

Mailing address

5445 N Kolb Rd Ste 205
Tucson, AZ 85750-0750

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
D010288AZMDGeneral Practice Dentistry
D10828ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ventana Canyon Dentistry, PLLC General Practice CurrentSince Mar 24, 2024 Accepting new patients

Locations

5445 N Kolb Rd
Ste 205
Tucson, AZ 85750
Phone (520) 577-7667

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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1881180669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 N KOLB RD STE 205",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857500750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 N KOLB RD STE 205",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857500750",
            "telephone_number": "520-577-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALEXANDRA",
        "middle_name": "TRINIDAD QUIROZ",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10828",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.