Provider Demographics
NPI:1811451818
Name:MARTINEZ, SARAH JEAN LINDSAY
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEAN LINDSAY
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1738
Mailing Address - Country:US
Mailing Address - Phone:510-652-8855
Mailing Address - Fax:
Practice Address - Street 1:2334 POWELL ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1738
Practice Address - Country:US
Practice Address - Phone:510-652-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1033081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice