Clint Martin, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

019029025 Issued in IL

Practice address

232 E Knoxville St
Brimfield, IL 61517-8103

Phone

(309) 320-8750

NPI assigned

Jun 28, 2012

Last updated

Apr 15, 2021By the provider in NPPES

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 IL

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

Practice roles

Locations

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

• Brimfield Family Dentistry, P.C.

  • Dental Clinic/Center
  • Brimfield, IL
  • NPI 1568072668
  NPD Authorized official

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1588928006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 E KNOXVILLE ST",
            "city": "BRIMFIELD",
            "state": "IL",
            "postal_code": "615178103",
            "telephone_number": "309-396-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 E KNOXVILLE ST",
            "city": "BRIMFIELD",
            "state": "IL",
            "postal_code": "615178103",
            "telephone_number": "309-320-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CLINT",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Funk, DMD
• Samantha Marie Haeffner
• Andrea Jane Hoerr, APN
• Jamie Leanne Kumar, DDS
• Randy Eugene Lloyd, LMT
• Marcia Mattern, CD (DONA)
• Susan Mayo
• Sarah Lynn Moon, M.A., CCC-SLP
• Maria Gabriela Rodriguez Mantilla, DDS
• Curtis Bruce Sherman, RPH

• Dentist in Brimfield, IL
• Providers in Brimfield, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.