Healthcare Provider Details

I. General information

NPI: 1972431153
Provider Name (Legal Business Name): GABRIELLA MARTINEZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 PORTSMOUTH BLVD STE 107
CHESAPEAKE VA
23321-2140
US

IV. Provider business mailing address

994 THOMAS PL
VISTA CA
92084-4801
US

V. Phone/Fax

Practice location:
  • Phone: 757-979-6270
  • Fax:
Mailing address:
  • Phone: 760-500-9428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: