Provider Demographics
NPI:1104428127
Name:MARTINEZ PIMIENTA, MARIA V
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:V
Last Name:MARTINEZ PIMIENTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 STIRLING CENTER PL STE 1701
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5712
Mailing Address - Country:US
Mailing Address - Phone:352-404-5550
Mailing Address - Fax:407-674-2539
Practice Address - Street 1:760 BROADWAY RM 2C319
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-960-8310
Practice Address - Fax:718-630-3244
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN261891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics