Individual provider Active NPI

Martin Joseph Dodd

  • Optician
  • Eureka, CA
National Provider Identifier
1649040700
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
5746 Issued in CA
Practice address
2039 Harrison Ave
Eureka, CA 95501-3211
Phone
(707) 445-2079
Fax
(707) 445-2070
NPI assigned
Jan 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 5746 CA Primary

Addresses

Primary practice location

2039 Harrison Ave
Eureka, CA 95501-3211

Mailing address

2039 Harrison Ave
Eureka, CA 95501-3211
Phone (707) 445-2079

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

Practice roles

OrganizationSpecialtyStatusNew patients
Six Rivers Optical, Inc. Optician CurrentSince Jan 14, 2024 Accepting new patients

Locations

2039 Harrison Ave
Eureka, CA 95501
Phone (707) 445-2079

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1649040700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013211",
            "telephone_number": "707-445-2079",
            "fax_number": "707-445-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013211",
            "telephone_number": "707-445-2079",
            "fax_number": "707-445-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "MARTIN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "5746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.