Provider Demographics
NPI:1518380476
Name:J.D.MARTINI, DMD, PS
Entity Type:Organization
Organization Name:J.D.MARTINI, DMD, PS
Other - Org Name:EMERGENCY DENTAL CARE FEDERAL WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JURGA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-661-5531
Mailing Address - Street 1:34507 PACIFIC HWY S
Mailing Address - Street 2:STE 9
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6879
Mailing Address - Country:US
Mailing Address - Phone:253-661-5531
Mailing Address - Fax:253-661-0885
Practice Address - Street 1:34507 PACIFIC HWY S
Practice Address - Street 2:STE 9
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6879
Practice Address - Country:US
Practice Address - Phone:253-661-5531
Practice Address - Fax:253-661-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603368975261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental