Individual provider Active NPI

Richard Earl Martzke, DDS

  • Dentist
  • Grand Ledge, MI
National Provider Identifier
1508904004
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901010346 Issued in MI
Practice address
311 Harrison St
Grand Ledge, MI 48837-1532
Phone
(517) 627-2422
Fax
(517) 627-7549
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901010346 MI Primary

Addresses

Primary practice location

311 Harrison St
Grand Ledge, MI 48837-1532

Mailing address

311 Harrison St
Grand Ledge, MI 48837-1532
Phone (517) 627-2422

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Counseling Services of Greater Lansing LLC PastSince Apr 29, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508904004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 HARRISON ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488371532",
            "telephone_number": "517-627-2422",
            "fax_number": "517-627-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 HARRISON ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488371532",
            "telephone_number": "517-627-2422",
            "fax_number": "517-627-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTZKE",
        "first_name": "RICHARD",
        "middle_name": "EARL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901010346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Ledge, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.