Individual provider Active NPI

Leonard J Martin, DDS

  • General Practice Dentistry
  • Oneida, TN
National Provider Identifier
1265761498
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS3271 Issued in TN
Practice address
474 Industrial LN
Oneida, TN 37841-6294
Phone
(423) 286-8600
Fax
(423) 286-8644
NPI assigned
Dec 17, 2009
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS3271 TN Primary
General Practice Dentistry 1223G0001X 003271 TN

Addresses

Primary practice location

474 Industrial LN
Oneida, TN 37841-6294

Mailing address

470 Industrial LN
Oneida, TN 37841-6294
Phone (423) 286-8600

Other identifiers 1

IdentifierTypeStateIssuer
DS3271OtherTNTENNESSEE STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230301001163 TN Practitioner - Dentist 8921304627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003271TNMDGeneral Practice Dentistry
DS3271TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain People's Health Councils, Inc CurrentSince Feb 7, 2023 Accepting new patients
Mountain Peoples Health Councils Inc CurrentSince Feb 7, 2023 Accepting new patients
Mountain Peoples Health Councils Inc Current Accepting new patients
Mountain Peoples Health Councils Inc Current Accepting new patients

Locations

3826 Norma Rd
Huntsville, TN 37756
Phone (423) 663-2900

470 Industrial Ln
Oneida, TN 37841
Phone (423) 663-9200

474 Industrial Ln
Oneida, TN 37841
Phone (423) 286-8600

Interoperability endpoints

  • Direct secure messaging: leonard.martin.d1.p1@direct.chetn.nextgenshare.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1265761498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 INDUSTRIAL LN",
            "city": "ONEIDA",
            "state": "TN",
            "postal_code": "378416294",
            "telephone_number": "423-286-8600",
            "fax_number": "423-286-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 INDUSTRIAL LN",
            "city": "ONEIDA",
            "state": "TN",
            "postal_code": "378416294",
            "telephone_number": "423-286-8600",
            "fax_number": "423-286-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LEONARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-17",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3271",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "003271",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE STATE LICENSE",
            "identifier": "DS3271",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, TN

Sources for this page

Verify at the official NPI Registry.