Nathan S. Martin, DDS, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12012108A Issued in IN

Legal business name

NATHAN S. MARTIN, DDS, LLC

Practice address

625 E Bristol St Ste a
Elkhart, IN 46514-3476

Phone

(317) 519-6978

NPI assigned

Dec 11, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Nathan S Martin, D.D.S.

Title

Owner/Dentist

Phone

(317) 519-6978

Specialties & licenses 1

Addresses

Other names 1

• Northside Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1497153142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7933 WINDHILL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561820",
            "telephone_number": "317-519-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BRISTOL ST STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143476",
            "telephone_number": "317-519-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN S. MARTIN, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "317-519-6978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012108A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.