Provider Demographics
NPI:1336592658
Name:J MARTINI DMD PLLC
Entity Type:Organization
Organization Name:J MARTINI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JURGA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-661-0461
Mailing Address - Street 1:34507 PACIFIC HWY S
Mailing Address - Street 2:SUITE 8
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6879
Mailing Address - Country:US
Mailing Address - Phone:253-661-0461
Mailing Address - Fax:
Practice Address - Street 1:34507 PACIFIC HWY S
Practice Address - Street 2:SUITE 8
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6879
Practice Address - Country:US
Practice Address - Phone:253-661-0461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA87041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty