Provider Demographics
NPI:1003363672
Name:MARTINS, JEFFREY (DDS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MARTINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6832 BAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-2500
Mailing Address - Country:US
Mailing Address - Phone:941-962-8480
Mailing Address - Fax:240-313-9661
Practice Address - Street 1:1711 LAKEWOOD RANCH BLVD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4906
Practice Address - Country:US
Practice Address - Phone:941-962-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist