Jason Ellis Martin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8173 Issued in NC

Practice address

236 Market St
Suite 200
Locust, NC 28097-9438

Phone

(704) 781-0500

Fax

(704) 781-0555

NPI assigned

Sep 16, 2006

Last updated

Jan 23, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1619073533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MARKET ST",
            "address_2": "SUITE 200",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280979438",
            "telephone_number": "704-781-0500",
            "fax_number": "704-781-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 MARKET ST",
            "address_2": "SUITE 200",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280979438",
            "telephone_number": "704-781-0500",
            "fax_number": "704-781-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JASON",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Locust, NC
• Providers in Locust, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.