Active NPI
Steven Douglas Martin, DMD
- General Practice Dentistry
- Alpharetta, GA
National Provider Identifier
1184714339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10809
- Practice address
- 1495 Alpharetta Hwy
Suite J
Alpharetta, GA 30004-2077 - Phone
- (770) 664-1342
- Fax
- (770) 664-1359
- NPI assigned
- Oct 16, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10809 | GA | Primary |
Addresses
Primary practice location
1495 Alpharetta Hwy
Suite J
Alpharetta, GA 30004-2077
Mailing address
1495 Alpharetta Hwy
Suite J
Alpharetta, GA 30004-2077
Phone (770) 664-1342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 9, 2015 through Nov 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10809 | GA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184714339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1495 ALPHARETTA HWY",
"address_2": "SUITE J",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300042077",
"telephone_number": "770-664-1342",
"fax_number": "770-664-1359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1495 ALPHARETTA HWY",
"address_2": "SUITE J",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300042077",
"telephone_number": "770-664-1342",
"fax_number": "770-664-1359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "STEVEN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "10809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpharetta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.