Active NPI
Marty E Gamble, DDS
- General Practice Dentistry
- Crofton, KY
National Provider Identifier
1639223233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7523
- Practice address
- 136 East Princeton St
Crofton, KY 42217 - Phone
- (270) 424-5999
- Fax
- (270) 424-5522
- NPI assigned
- Jan 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7523 | KY | Primary |
Addresses
Primary practice location
136 East Princeton St
Crofton, KY 42217
Mailing address
136 East Princeton St
Crofton, KY 42217
Phone (270) 424-5999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60000304 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7523 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crofton Dental Center PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Crofton, KY
- NPI 1982904637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639223233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 EAST PRINCETON ST",
"city": "CROFTON",
"state": "KY",
"postal_code": "42217",
"telephone_number": "270-424-5999",
"fax_number": "270-424-5522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 EAST PRINCETON ST",
"city": "CROFTON",
"state": "KY",
"postal_code": "42217",
"telephone_number": "270-424-5999",
"fax_number": "270-424-5522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBLE",
"first_name": "MARTY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "7523",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60000304",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crofton, KY
- Crofton Dental Center PLLC
- Crofton Elementary School
- Crofton Pharmacy LLC (Crofton Pharmacy)
- Crofton Pharmacy, LLC (Crofton Pharmacy)
- Jerri Annette Fowler, SLP
- Jennie Stuart Medical Center Inc (Jennie Stuart Health Family Health Crofton RHC)
- Kirsten Myrick
- Angela D Pogue, APRN, FNP-C
- Sydney E Rodgers
- Rosalind Renee Sheffield, LPCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.