Individual provider Active NPI

Christina Anna Martin, DMD

  • Endodontics
  • Virginia Beach, VA
National Provider Identifier
1366007601
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401416920 Issued in VA
Practice address
1432 N Great Neck Rd Ste 102
Virginia Beach, VA 23454-1342
Phone
(757) 486-7857
Fax
(757) 486-4441
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 390200000X NC
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 0401416920 VA Primary

Addresses

Primary practice location

1432 N Great Neck Rd Ste 102
Virginia Beach, VA 23454-1342

Mailing address

2120 W Admiral Dr
Virginia Beach, VA 23451-1764
Phone (937) 620-5713

Other practice location 1

150 Bee St Apt 706
Charleston, SC 29401-5706
Phone (937) 620-5713

Other practice location 2

1369 Laskin Rd Ste 3B
Virginia Beach, VA 23451-6080
Phone (937) 620-5713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401416920VAMDEndodontist
390200000XNCMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1366007601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 W ADMIRAL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511764",
            "telephone_number": "937-620-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 N GREAT NECK RD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234541342",
            "telephone_number": "757-486-7857",
            "fax_number": "757-486-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Bee St Apt 706",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294015706",
            "country_code": "US",
            "telephone_number": "937-620-5713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1369 Laskin Rd Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234516080",
            "country_code": "US",
            "telephone_number": "937-620-5713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTINA",
        "middle_name": "ANNA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401416920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.