Provider Demographics
NPI:1124785688
Name:MARTINS, NATASSIA RODRIGUES (DMD)
Entity type:Individual
Prefix:DR
First Name:NATASSIA
Middle Name:RODRIGUES
Last Name:MARTINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 LEE BARTON DR UNIT 216
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1044
Mailing Address - Country:US
Mailing Address - Phone:949-748-0514
Mailing Address - Fax:
Practice Address - Street 1:3500 JEFFERSON ST STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6220
Practice Address - Country:US
Practice Address - Phone:512-451-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX379991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice