Individual provider Active NPI

Chelsea Jo Martin, D.D.S.

  • Dentist
  • Houston, TX
National Provider Identifier
1386026169
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31078 Issued in TX
Practice address
4005 Broadway St
Houston, TX 77087-4703
Phone
(713) 644-4331
NPI assigned
Jun 29, 2015
Last updated
Jun 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31078 TX Primary

Addresses

Primary practice location

4005 Broadway St
Houston, TX 77087-4703

Mailing address

4005 Broadway St
Houston, TX 77087-4703
Phone (713) 644-4331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230622002025 TX Order and Referring Only - DentistPractitioner - Dentist 1355709486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31078TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1386026169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 BROADWAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770874703",
            "telephone_number": "713-644-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 BROADWAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770874703",
            "telephone_number": "713-644-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHELSEA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.