Individual provider Active NPI

Paul J Martin, DDS

  • Dentist
  • Chiloquin, OR
National Provider Identifier
1013917178
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D8532 Issued in OR
Practice address
330 Chiloquin Blvd
Chiloquin, OR 97624-6773
Phone
(800) 246-7894
Fax
(541) 783-2028
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D8532 OR Primary

Addresses

Primary practice location

330 Chiloquin Blvd
Chiloquin, OR 97624-6773

Mailing address

3949 S 6TH St
Klamath Falls, OR 97603-4746
Phone (800) 552-6290

Other identifiers 1

IdentifierTypeStateIssuer
129861MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D8532ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1013917178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 S 6TH ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034746",
            "telephone_number": "800-552-6290",
            "fax_number": "541-880-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CHILOQUIN BLVD",
            "city": "CHILOQUIN",
            "state": "OR",
            "postal_code": "976246773",
            "telephone_number": "800-246-7894",
            "fax_number": "541-783-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129861",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chiloquin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.