Provider Demographics
NPI:1508087495
Name:JON C MARTINEZ DDS INC
Entity Type:Organization
Organization Name:JON C MARTINEZ DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-642-4200
Mailing Address - Street 1:7030 W 107TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1898
Mailing Address - Country:US
Mailing Address - Phone:913-642-4200
Mailing Address - Fax:913-642-4260
Practice Address - Street 1:7030 W 107TH ST STE 220
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1898
Practice Address - Country:US
Practice Address - Phone:913-642-4200
Practice Address - Fax:913-642-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty