Cornelius Devante Martin, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

11588 Issued in NC

Practice address

2605 Forest Hills Rd SW Ste B
Wilson, NC 27893-4448

Phone

(252) 512-4144

NPI assigned

May 31, 2019

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1023676434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 FOREST HILLS RD SW STE B",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934448",
            "telephone_number": "252-512-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 FOREST HILLS RD SW STE B",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934448",
            "telephone_number": "252-512-4144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2702 Medical Office Pl",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275349460",
            "country_code": "US",
            "telephone_number": "919-617-4035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Oleander Dr",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275274561",
            "country_code": "US",
            "telephone_number": "919-879-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CORNELIUS",
        "middle_name": "DEVANTE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "11588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald F Marascalco, PA-C
• Craig Markowski, DPT, MPT
• Amy Marlow
• Melissa Williamson Marshall
• Brittany Marshburn, PA-C
• Leighanna Grace Martin, FNP-C
• Lewis Paul Martin, MD
• Melissa Martini, FNTP
• Mary'S Home
• Carle Woodruff Mason Jr., DDS

• Pediatric Dentistry in Wilson, NC
• Providers in Wilson, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.