John A Martin, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS018149L Issued in PA

Practice address

2521 Carnegie Dr
State College, PA 16803-1157

Phone

(814) 234-4997

Fax

(814) 234-4997

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1508860040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 CARNEGIE DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031157",
            "telephone_number": "814-234-4997",
            "fax_number": "814-234-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 CARNEGIE DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031157",
            "telephone_number": "814-234-4997",
            "fax_number": "814-234-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS018149L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin & Suhey Orthopedics, P.C.
• Abigail Grace Martin, PA-C
• Elizabeth Marie Martin, D.O.
• James S Martin, M.D.
• Jill Martin, PA-C
• Kaylee Martin, LMT
• Kirsten Mascaritola, PHARMD
• Elizabeth Ann Mason, LMSW
• Jonathan Michael Masorti, D.C.
• Joshua Masorti, DC

• Periodontics in State College, PA
• Providers in State College, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.