Kelly Martin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020677 Issued in MI

Practice address

G4007 W Court St
#D
Flint, MI 48532-3560

Phone

(810) 230-0077

NPI assigned

Jun 1, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1013278464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G4007 W COURT ST",
            "address_2": "#D",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-230-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G4007 W COURT ST",
            "address_2": "#D",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-230-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELLY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Martin, LMT
• Jacob Martin, PA-C
• Joelle Brittney Martin, NP
• Kali Christine Martin
• Katie Martin, PHARMD
• Maizie Martin
• Mary K Martin, CRNA
• Matthew Martin
• Maxwell Thomas Martin
• Natalie Martin, RN, FNP

• General Practice Dentistry in Flint, MI
• Providers in Flint, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.