Provider Demographics
NPI:1114555687
Name:MARTINEZ, YVETTE ALEXIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:ALEXIS
Last Name:MARTINEZ
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 1:418 GETTYSBURG ST
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4882
Mailing Address - Country:US
Mailing Address - Phone:972-322-5378
Mailing Address - Fax:
Practice Address - Street 1:25235 IH 10 W STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-2105
Practice Address - Country:US
Practice Address - Phone:210-879-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35247122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice