MEDICARE: CHRISTOPHER JAMES MARTINEZ DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6638	NV

General Provider Information

NPI Number	:	1811370414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES MARTINEZ DMD

Provider Business Mailing Address
First Line	:	11425 ROCK COVE WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3217
Country	:	US
Telephone Number	:	702-767-0343
Fax Number	:

Provider Business Practice Location Address
First Line	:	7730 W CHEYENNE AVE STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8412
Country	:	US
Telephone Number	:	702-658-8008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	07/01/2015

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