Martin Dental Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MARTIN DENTAL ASSOCIATES PC

Practice address

501 North Main Street
Flora, IL 62839

Phone

(618) 662-2025

Fax

(618) 662-2911

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Harold Lee Marin, DDS

Title

Owner

Phone

(618) 662-2025

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043365968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "62839",
            "telephone_number": "618-662-2025",
            "fax_number": "618-662-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NORTH MAIN STREET",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "62839",
            "telephone_number": "618-662-2025",
            "fax_number": "618-662-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-662-2025",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101453",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan J Mack, RN, FNP
• Marion County Horizon Center D/B/a Prairie Estates
• Marion Eye Centers LTD.
• Roger Allen Marks
• Robert Neil Marley, D.D.S.
• Laurel Mae Mason, RN
• Marissa Lynnae Maxham, PTA
• Karen Louise McAllister, APRN
• Tina McGee, BA
• Michelle Morgan

• General Practice Dentistry in Flora, IL
• Providers in Flora, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.