Provider Demographics
NPI:1205455896
Name:MARTINEZLOPEZ, YUNIESKY (DDS)
Entity type:Individual
Prefix:
First Name:YUNIESKY
Middle Name:
Last Name:MARTINEZLOPEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 ZAPATA CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4806
Mailing Address - Country:US
Mailing Address - Phone:727-623-3279
Mailing Address - Fax:
Practice Address - Street 1:1700 SAND LAKE RD STE D114
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-9149
Practice Address - Country:US
Practice Address - Phone:407-517-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN273721223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice