Provider Demographics
NPI:1588235535
Name:MARTINONI, ARIKA LANEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARIKA
Middle Name:LANEE
Last Name:MARTINONI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 CARMODY RD
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-9413
Mailing Address - Country:US
Mailing Address - Phone:707-548-1410
Mailing Address - Fax:
Practice Address - Street 1:2436 FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1209
Practice Address - Country:US
Practice Address - Phone:707-942-5177
Practice Address - Fax:707-942-4465
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1062531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice