Douglas R. Martin DDS SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2602-15 Issued in WI

Legal business name

DOUGLAS R. MARTIN DDS SC

Practice address

2905 S 12TH St
Sheboygan, WI 53081-6705

Phone

(616) 406-9399

NPI assigned

Sep 16, 2009

Last updated

Oct 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Richard Martin, D.D.S.NPI 1295968634

Title

Sole Member

Phone

(616) 406-9399

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Richard Martin, D.D.S.

  • Dentist
  • Mequon, WI
  • NPI 1295968634
  NPD (past) Authorized official

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1518290980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W GLEN OAKS LN",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922902",
            "telephone_number": "616-406-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 S 12TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816705",
            "telephone_number": "616-406-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS R. MARTIN DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "616-406-9399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2602-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah R Dole
• Jamie S Dolfin, P.T.
• Emily J Domaille, PTA
• Kelly Donnelly Mueller, D.O.
• Katharine A Donohue, FNP-C
• Rebecca Ann Dourn, COTA
• Madison Dowidat
• Kaitlin Marie Downey, OTR, CLT
• Lisa Dozier, LPC
• Dr Kevin S Myers MDSC

• General Practice Dentistry in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.