Martin D McMahon, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DS022967L Issued in PA

Practice address

2888 Sr 29S Ste 1
Monroe Noxen Health Center
Monroe Township, PA 18636-9766

Phone

(570) 298-2161

Fax

(570) 298-2148

NPI assigned

Oct 23, 2006

Last updated

Sep 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Rural Health Corporation of Northeastern Pennsylvania

  • Federally Qualified Health Center (FQHC)
  • Wilkes Barre, PA
  • NPI 1437351640

  Dentist

  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1689757601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 ROUTE 315",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187027012",
            "telephone_number": "570-825-8741",
            "fax_number": "570-825-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 SR 29S STE 1",
            "address_2": "MONROE NOXEN HEALTH CENTER",
            "city": "MONROE TOWNSHIP",
            "state": "PA",
            "postal_code": "186369766",
            "telephone_number": "570-298-2161",
            "fax_number": "570-298-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "MARTIN",
        "middle_name": "D",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS022967L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008588550002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Bowen, PHDH
• Butler Vamc
• Gwendolyn Galasso, M.D.
• Yasser Iskandarani, DMD
• Hemali B Javia, D.D.S.
• Maureen Reid, MA, LPC, NCC
• Rural Health Corporation of Northeastern Pennsylvania (Monroe-Noxen Health Center)

• Dentist in Monroe Township, PA
• Providers in Monroe Township, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.