Blake Austin Martin, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

61913 Issued in KS

Practice address

8310 State Ave
Kansas City, KS 66112-1841

Phone

(913) 334-5225

NPI assigned

Mar 27, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1609526144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22157 207TH ST",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "660864139",
            "telephone_number": "913-485-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121841",
            "telephone_number": "913-334-5225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22157 207th St",
            "address_purpose": "LOCATION",
            "city": "Tonganoxie",
            "state": "KS",
            "postal_code": "660864139",
            "country_code": "US",
            "telephone_number": "913-485-9878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BLAKE",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61913",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth D Marshall, M.D.
• Victoria Kay Marshall, MD
• Kaoru Williams Martens, M.D.
• Martha L Hurley MD Dba Associates in Womens Care
• Angela Sue Martin
• Erin Ann Martin, APRN CNM
• James Lucas Martin
• Jessi Gabrielle Martin, MSW, LMSW-T
• Maria Fabi Martin, MD
• Norman L Martin, M.D.

• Dentist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Dentist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.