Douglas Richard Martin, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2602-15 Issued in WI

Practice address

1808 W Glen Oaks LN
Mequon, WI 53092-2902

Phone

(616) 406-9399

NPI assigned

Sep 2, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Douglas R. Martin DDS SC

  • General Practice Dentistry
  • Sheboygan, WI
  • NPI 1518290980
  NPD (past) Authorized official

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1295968634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W GLEN OAKS LN",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922902",
            "telephone_number": "616-406-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 W GLEN OAKS LN",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922902",
            "telephone_number": "616-406-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DOUGLAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-02",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2602-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika L Mantsch, PA-C
• Delan Joshua Manzo
• Irwin Margolis, M.D.
• Mark W Niedfeldt, MD, LLC
• Kayla Markle
• Brian Shawn Martinezdelacotera, LPC
• Maryam K Doyle MD SC
• Michael Antonio Marzette Jr.
• Diane Matel, APNP, PHD
• Anne L Mattson, MD

• Dentist in Mequon, WI
• Providers in Mequon, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.