Active NPI
Carly Martin
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1477046944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS104018
- Practice address
- 5670 Wilshire Blvd Ste 1700
Los Angeles, CA 90036-5626 - Phone
- (310) 529-1127
- NPI assigned
- Jun 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS104018 | CA | Primary |
Addresses
Primary practice location
5670 Wilshire Blvd Ste 1700
Los Angeles, CA 90036-5626
Mailing address
5670 Wilshire Blvd Ste 1700
Los Angeles, CA 90036-5626
Phone (310) 529-1127
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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS104018 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581724800000",
"number": "1477046944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5670 WILSHIRE BLVD STE 1700",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900365626",
"telephone_number": "310-529-1127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5670 WILSHIRE BLVD STE 1700",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900365626",
"telephone_number": "310-529-1127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CARLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2020-02-15",
"certification_date": "2020-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS104018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.