Provider Demographics
NPI:1093412363
Name:MARTINEZ, PAMELA NABELLE HILO
Entity Type:Individual
Prefix:DR
First Name:PAMELA NABELLE
Middle Name:HILO
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 MCKEE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1615
Mailing Address - Country:US
Mailing Address - Phone:408-914-1802
Mailing Address - Fax:
Practice Address - Street 1:2340 MCKEE RD STE 2
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1615
Practice Address - Country:US
Practice Address - Phone:408-914-1802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist