Provider Demographics
NPI:1700448297
Name:MARTINI, SAMI (DDS)
Entity Type:Individual
Prefix:
First Name:SAMI
Middle Name:
Last Name:MARTINI
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 1:8515 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7075
Mailing Address - Country:US
Mailing Address - Phone:630-880-8465
Mailing Address - Fax:
Practice Address - Street 1:17160 W NORTH AVE STE 101
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4437
Practice Address - Country:US
Practice Address - Phone:262-782-1655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002151-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice