Individual provider Active NPI

John Quinn Martino, D.D.S.

  • General Practice Dentistry
  • Pawleys Island, SC
National Provider Identifier
1235580937
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9695 Issued in SC
Practice address
10030 Ocean Hwy
Pawleys Island, SC 29585-7805
Phone
(843) 237-8433
Fax
(843) 237-1073
NPI assigned
Jun 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4227 WV
General Practice Dentistry 1223G0001X 10188 KY
General Practice Dentistry 1223G0001X 9695 SC Primary

Addresses

Primary practice location

10030 Ocean Hwy
Pawleys Island, SC 29585-7805

Mailing address

PO Box 2369
Anniston, AL 36202-2369
Phone (256) 741-7340

Other practice location 1

2500 W Broadway Ste 100
Louisville, KY 40211-1184
Phone (502) 776-1754

Other practice location 2

2000 Industrial Rd E Ste 200
Bridgeport, WV 26330-1297
Phone (304) 933-5300

Other practice location 3

1175 S Main St Ste 4
Madisonville, KY 42431-3337
Phone (270) 383-5511

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4227WVMDDentist
9695SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care of Kentucky, Inc General Practice Past Accepting new patients
Dr. Robert Martino, PLLC Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1235580937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2369",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362022369",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 OCEAN HWY",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857805",
            "telephone_number": "843-237-8433",
            "fax_number": "843-237-1073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W Broadway Ste 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402111184",
            "country_code": "US",
            "telephone_number": "502-776-1754",
            "fax_number": "502-778-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Industrial Rd E Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263301297",
            "country_code": "US",
            "telephone_number": "304-933-5300",
            "fax_number": "304-933-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 S Main St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "424313337",
            "country_code": "US",
            "telephone_number": "270-383-5511",
            "fax_number": "270-821-9602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "JOHN",
        "middle_name": "QUINN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "4227",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10188",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawleys Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.