Active NPI
Ken Martin, DDS
- Dentist
- New Port Richey, FL
National Provider Identifier
1679559231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN6905
- Practice address
- 4138 Madison St
New Port Richey, FL 34652-6060 - Phone
- (727) 849-0705
- Fax
- (727) 847-3851
- NPI assigned
- Dec 15, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN6905 | FL | Primary |
Addresses
Primary practice location
4138 Madison St
New Port Richey, FL 34652-6060
Mailing address
4138 Madison St
New Port Richey, FL 34652-6060
Phone (727) 849-0705
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 |
|---|---|---|---|
| DN6905 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679559231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4138 MADISON ST",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346526060",
"telephone_number": "727-849-0705",
"fax_number": "727-847-3851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4138 MADISON ST",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346526060",
"telephone_number": "727-849-0705",
"fax_number": "727-847-3851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN6905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Port Richey, FL
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.