Martineau Dentistry
Dentist, General Practice in Surprise, AZ. Organization (NPI-2).
Details
- NPI
- 1215489141
- Entity type
- Organization (NPI-2)
- Legal business name
- Martineau Dentistry
- Organization subpart
- No
- Enumeration date
- Oct 26, 2016
- Last updated
- Oct 26, 2016
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 | D6112 | AZ | Yes |
Practice location
15341 W Waddell RdSuite B107
Surprise, AZ 85379-5169
Phone 623-975-3933 · Fax 623-975-3493
Mailing address
15341 W Waddell RdSuite B107
Surprise, AZ 85379-5169
Phone 623-975-3933 · Fax 623-975-3493
Authorized official
Brent Martineau
Owner/Dentist
6239753933
Is something wrong?
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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