Healthcare Provider Details
I. General information
NPI: 1023390523
Provider Name (Legal Business Name): ALMA MARTINEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/12/2011
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 S PARADISE AVE
MIDDLETON ID
83644-5809
US
IV. Provider business mailing address
12376 S ESSEX WAY
NAMPA ID
83686-5190
US
V. Phone/Fax
- Phone: 208-585-0048
- Fax: 208-466-5359
- Phone: 208-899-6838
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | D-PR-4382 |
| License Number State | ID |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 7486 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: