Jeanny Tejeda Martin
Dentist, General Practice in Burbank, CA. Individual provider (NPI-1).
NPI number1093459232
StatusActive
Last updated in NPPESMay 26, 2024
Details
- NPI
- 1093459232
- Entity type
- Individual (NPI-1)
- Name
- Jeanny Tejeda Martin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 25, 2022
- Certification date
- May 26, 2024
- Last updated
- May 26, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 108631 | CA | Yes |
Practice location
2800 W Magnolia BlvdBurbank, CA 91505-3036
Phone 818-846-9041
Mailing address
2801 Sunset Pl Apt 1407Los Angeles, CA 90005-4482
Phone 857-492-4099
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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