Provider Demographics
NPI:1659392272
Name:MARTINEZ, TIMOTHY STEVEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:STEVEN
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8657 CAMDEN DR
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3926
Mailing Address - Country:US
Mailing Address - Phone:619-873-3545
Mailing Address - Fax:
Practice Address - Street 1:590 PALM CANYON DR # 212
Practice Address - Street 2:
Practice Address - City:BORREGO SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92004-4000
Practice Address - Country:US
Practice Address - Phone:760-767-5112
Practice Address - Fax:760-767-5613
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166331223G0001X
CADDS583231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice