Individual provider Active NPI

Jacqueline S Harris Martin, DDS

  • General Practice Dentistry
  • Washington, DC
National Provider Identifier
1376727206
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5580 Issued in DC
Practice address
818 18TH St NW
747
Washington, DC 20006-3513
Phone
(202) 330-1688
Fax
(877) 404-8207
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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 5580 DC Primary
General Practice Dentistry 1223G0001X 13229 MD

Addresses

Primary practice location

818 18TH St NW
747
Washington, DC 20006-3513

Mailing address

818 18TH St NW
747
Washington, DC 20006-3513
Phone (202) 330-1688

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5580DCMDGeneral Practice Dentistry
13229MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1376727206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 18TH ST NW",
            "address_2": "747",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200063513",
            "telephone_number": "202-330-1688",
            "fax_number": "877-404-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 18TH ST NW",
            "address_2": "747",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200063513",
            "telephone_number": "202-330-1688",
            "fax_number": "877-404-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS MARTIN",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "5580",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.