Brent Erickson Martin, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60029611 Issued in WA

Practice address

1721 E Lincoln Ave
Sunnyside, WA 98944-2478

Phone

(509) 837-7178

Fax

(509) 837-3117

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Brent Martin DMD PLLC

  dba River Rock Dental

  • General Practice Dentistry
  • Zillah, WA
  • NPI 1194539577
  NPD Authorized official
• B. Martin DMD PLLC

  dba Community Dental Care of Zillah

  • General Practice Dentistry
  • Zillah, WA
  • NPI 1609168756
  NPD (past) Authorized official

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1447412580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442478",
            "telephone_number": "509-837-4022",
            "fax_number": "509-839-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442478",
            "telephone_number": "509-837-7178",
            "fax_number": "509-837-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRENT",
        "middle_name": "ERICKSON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60029611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5057039",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DENTAL LICENSE",
            "identifier": "DE60029611",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Madrigal
• Salman Mandhai, DO
• Marc G. Meininger, M.D.
• Vanessa Martel
• Martin & Rodriguez Dental Center PLLC
• Gary Erickson Martin, DDS
• Martin, Martin & Copeland PLLC (Community Dental Orthodontics)
• Martin, Martin & Copeland PLLC (Community Dental Care)
• Susana Martinez
• Marty Mathison LMP

• Dentist in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.