NPIMap

Organization Active NPI

B. Martin DMD PLLC

Doing business as Community Dental Care of Zillah

  • General Practice Dentistry
  • Zillah, WA
National Provider Identifier
1609168756
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
B. MARTIN DMD PLLC
Doing business as
Community Dental Care of Zillah
Practice address
812 Zillah West Rd
Zillah, WA 98953
Phone
(509) 829-6288
Fax
(509) 314-6603
NPI assigned
May 9, 2011
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Dr. Brent E Martin, DMDNPI 1447412580
Title
Doctor/Owner
Phone
(509) 314-6600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

812 Zillah West Rd
Zillah, WA 98953

Mailing address

812 Zillah West Rd
Zillah, WA 98953
Phone (509) 829-6288

Other identifiers 2

IdentifierTypeStateIssuer
5057039MedicaidWA
2251024MedicaidWA

Other names 1

  • Community Dental Care of Zillah Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1609168756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 ZILLAH WEST RD",
            "city": "ZILLAH",
            "state": "WA",
            "postal_code": "98953",
            "telephone_number": "509-829-6288",
            "fax_number": "509-314-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 ZILLAH WEST RD",
            "city": "ZILLAH",
            "state": "WA",
            "postal_code": "98953",
            "telephone_number": "509-829-6288",
            "fax_number": "509-314-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B. MARTIN DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "509-314-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5057039",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2251024",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Dental Care of Zillah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zillah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.