Maria H. Martinson, D.M.D.
Individual provider Active NPI General Practice Dentistry · Sylvania, GA
NPI 1619986320 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619986320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 11086 (GA)
- Practice address
- 112 Clifford Ave
Sylvania, GA 30467-2012 - Phone
- (912) 564-7107
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11086 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clifford Avenue Dental LLC | General Practice | Past |
Accepting new patients |
| Screven Dental | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11086 | GA | Yes |
Addresses
Primary practice location
112 Clifford Ave
Sylvania, GA 30467-2012
Mailing address
611 S Main St
Sylvania, GA 30467-2229
Phone (912) 564-2263
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00590543A | Medicaid | GA |
Other providers in Sylvania, GA
- Mary Beth Jones-Godbee
- William Kent
- Kayla Kirkland
- Marian Lane
- Dakota Michelle Lee
- Amanda Brooke McBride
- Sidney James Morgan
- Sidney Joseph Morgan
- MPPG, Inc.
- Ogeechee Behavioral Health Services
All providers in Sylvania, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.