E. Dale Martin, D.D.S., M.S.D., P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13263 Issued in TX

Legal business name

E. DALE MARTIN, D.D.S., M.S.D., P.C.

Practice address

3904 Boat Club Rd
Lake Worth, TX 76135-3201

Phone

(817) 238-6450

Fax

(817) 238-6497

NPI assigned

May 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eddy Dale Martin, D.D.S.NPI 1144261975

Title

Dentist

Phone

(817) 238-6450

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eddy Dale Martin, D.D.S.

  • Pediatric Dentistry
  • Lake Worth, TX
  • NPI 1144261975
  NPD (past) Authorized official

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689611527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 BOAT CLUB RD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353201",
            "telephone_number": "817-238-6450",
            "fax_number": "817-238-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 BOAT CLUB RD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353201",
            "telephone_number": "817-238-6450",
            "fax_number": "817-238-6497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. DALE MARTIN, D.D.S., M.S.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "EDDY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "817-238-6450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "13263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Kendra Dabelic, M.D.
• Nicole Ann Davault, OTR
• Gail Castillo Deguzman, DDS
• Denija Delic, LPC, NCC
• Dentists of Lake Worth PC
• Monica S Farias, MD
• Naima Garrett, MD
• Katherine Leigh Garza, PHARMD
• Austin Tanner Graham, BCBA
• Green Oaks Physical Therapy Limited Partnership

• Pediatric Dentistry in Lake Worth, TX
• Providers in Lake Worth, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.