Individual provider Active NPI

Jeffery Lynn Martin, D.D.S.

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1245302397
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D2381 Issued in AZ
Practice address
7350 E Speedway Blvd Ste 201
Tucson, AZ 85710-1366
Phone
(520) 600-6925
Fax
(520) 747-0148
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D2381 AZ Primary

Addresses

Primary practice location

7350 E Speedway Blvd Ste 201
Tucson, AZ 85710-1366

Mailing address

7350 E Speedway Blvd Ste 201
Tucson, AZ 85710-1366
Phone (520) 747-9024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20160107001248 AZ Order and Referring Only - DentistPractitioner - Dentist 1456653419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D2381AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Martin-Taylor Dentistry General Practice CurrentSince Oct 1, 2022 Accepting new patients

Locations

7350 E Speedway Blvd
Ste 201
Tucson, AZ 85710
Phone (520) 600-6925

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1245302397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 E SPEEDWAY BLVD STE 201",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101366",
            "telephone_number": "520-747-9024",
            "fax_number": "520-747-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 E SPEEDWAY BLVD STE 201",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101366",
            "telephone_number": "520-600-6925",
            "fax_number": "520-747-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEFFERY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D2381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.