Provider Demographics
NPI:1063628709
Name:MARTIN, ARMINITA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARMINITA
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14427 CHASE ST
Mailing Address - Street 2:SUITE #201
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402
Mailing Address - Country:US
Mailing Address - Phone:818-895-1055
Mailing Address - Fax:818-895-9098
Practice Address - Street 1:14427 CHASE ST
Practice Address - Street 2:SUITE #201
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-895-1055
Practice Address - Fax:818-895-9098
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50786122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9309301OtherMEDI CAL