Individual provider Active NPI

Martha M. Lawrence, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Gainesville, FL
National Provider Identifier
1417950320
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
FTP589 Issued in FL
Practice address
1395 Center Dr # D7-6a
Ufcd Oral and Maxillofacial Surgery, Box 100416
Gainesville, FL 32610-0416
Phone
(352) 273-6750
Fax
(352) 392-7609
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3065 ME
Oral and Maxillofacial Surgery (Dentist) 1223S0112X FTP589 FL Primary

Addresses

Primary practice location

1395 Center Dr # D7-6a
Ufcd Oral and Maxillofacial Surgery, Box 100416
Gainesville, FL 32610-0416

Mailing address

1395 Center Drive, D7-6a, Box 100416
Uf College of Dentistry Oral and Maxillofacial Surgery
Gainesville, FL 32610-0416
Phone (352) 273-6750

Other identifiers 2

IdentifierTypeStateIssuer
FTP589OtherFLUNIVERSITY OF FLORIDA TEACHING PERMIT
MM0862OtherMEPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130729000029 FL Practitioner - Oral Surgery 9436254448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FTP589FLMDOral and Maxillofacial Surgery (Dentist)
3065MEMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Associates Incorporated CurrentSince Jun 21, 2013 Accepting new patients
Central Maine Oral & Maxillofacial Surgery Associates, PA Oral and Maxillofacial Surgery PastSince Mar 22, 2007 Accepting new patients

Locations

1600 SW Archer Rd
Rm D26
Gainesville, FL 32610
Phone (352) 273-5380

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1417950320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CENTER DRIVE, D7-6A, BOX 100416",
            "address_2": "UF COLLEGE OF DENTISTRY ORAL AND MAXILLOFACIAL SURGERY",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100416",
            "telephone_number": "352-273-6750",
            "fax_number": "352-392-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR # D7-6A",
            "address_2": "UFCD ORAL AND MAXILLOFACIAL SURGERY, BOX 100416",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100416",
            "telephone_number": "352-273-6750",
            "fax_number": "352-392-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "MARTHA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "3065",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "FTP589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF FLORIDA TEACHING PERMIT",
            "identifier": "FTP589",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "MM0862",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.