Active NPI
William Martin, D.D.S.
- Dentist
- Tacoma, WA
National Provider Identifier
1083863849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2002000002
- Practice address
- 1717 S Union Ave
Tacoma, WA 98405-1997 - Phone
- (555) 867-5309
- NPI assigned
- Sep 16, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2002000002 | MO | Primary |
Addresses
Primary practice location
1717 S Union Ave
Tacoma, WA 98405-1997
Mailing address
555 5TH Blvd NE
Tacoma, WA 98405
Phone (555) 867-5309
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2002000002 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1083863849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 5TH BLVD NE",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "555-867-5309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S UNION AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984051997",
"telephone_number": "555-867-5309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-16",
"last_updated": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2002000002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.