Provider Demographics
NPI:1649083015
Name:MARTINEZ, ALEJANDRO (DDS)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:MARTINEZ
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 1:1534 E AMAR RD STE A
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1639
Mailing Address - Country:US
Mailing Address - Phone:626-965-4210
Mailing Address - Fax:626-965-4203
Practice Address - Street 1:1534 E AMAR RD STE A
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1639
Practice Address - Country:US
Practice Address - Phone:626-965-4210
Practice Address - Fax:626-965-4203
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111206122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist