Pamela Elizabeth Martin, D.D.S.
Individual provider Active NPI General Practice Dentistry · Middlefield, OH
NPI 1457571366 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457571366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30020240 (OH)
- Practice address
- 16022 East High Street
Middlefield, OH 44062 - Phone
- (440) 632-1908
- Fax
- (440) 632-1768
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150617000990 | OH | Order and Referring Only - Dentist |
0547571523 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30020240 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30020240 | OH | Yes |
Addresses
Primary practice location
16022 East High Street
Middlefield, OH 44062
Mailing address
16022 East High Street
PO Box 766
Middlefield, OH 44062
Phone (440) 632-1908
Other providers in Middlefield, OH
- Lenhart Chiropractic Clinic, Inc.
- Leonard John Lenhart
- Living Well Holistic Health, LLC
- Tyler Maurice Lowe
- Kaylin Mahoney
- Robert S Martin
- Nicolette Martorello
- Cassandra Mattix
- Alissa K Mazzocchi
- Mary McGroarty
All providers in Middlefield, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.