Malcolm Craig Macmartin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1123900 Issued in MI

Practice address

42434 Bradner CT
Plymouth, MI 48170-2501

Phone

(734) 420-0636

Fax

(734) 420-1024

NPI assigned

Apr 15, 2008

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1043484546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42434 BRADNER CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702501",
            "telephone_number": "734-420-0636",
            "fax_number": "734-420-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42434 BRADNER CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702501",
            "telephone_number": "734-420-0636",
            "fax_number": "734-420-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMARTIN",
        "first_name": "MALCOLM",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D1123900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ornella Machalany, PHARMD, RPH
• Michelle Lee Macinnis, LLPC, MS
• Kandice Mack
• Keri Marie Mack, BCBA
• Casey Maclean
• Macomb Primary Care, P.C
• Nicole Macon-McKendree, LMSW
• Joshua Madding, M.A., CCC-SLP
• Martha Madlambayan
• Danielle Renae Madrigal

• General Practice Dentistry in Plymouth, MI
• Providers in Plymouth, 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 Apr 15, 2008; 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.