Healthcare Provider Details

I. General information

NPI: 1598622607
Provider Name (Legal Business Name): CARLOS RENATO MARTINEZ MONTORO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HELEN POWER DR
VACAVILLE CA
95687-3507
US

IV. Provider business mailing address

6801 LEISURE TOWN RD APT 220
VACAVILLE CA
95688-9449
US

V. Phone/Fax

Practice location:
  • Phone: 707-451-8390
  • Fax:
Mailing address:
  • Phone: 407-824-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: