Martha Hardaway DMD Ms PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MARTHA HARDAWAY DMD MS PA

Doing business as

Bluebird Pediatric Dentistry

Practice address

247 Mount Jefferson State Park Rd Ste 7
West Jefferson, NC 28694-8042

Phone

(919) 604-1546

NPI assigned

Mar 24, 2021

Organization subpart

No

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

Authorized official

Name

Martha Hardaway, DMD MSNPI 1942365044

Title

President

Phone

(919) 604-1546

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Bluebird Pediatric Dentistry Doing business as

Locations

Practitioners 1

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

• Martha Hardaway, DMD

  • Pediatric Dentistry
  • Boone, NC
  • NPI 1942365044
  NPD Authorized official

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1710563176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 WIND WALKER CT",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075349",
            "telephone_number": "919-604-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 MOUNT JEFFERSON STATE PARK RD STE 7",
            "city": "WEST JEFFERSON",
            "state": "NC",
            "postal_code": "286948042",
            "telephone_number": "919-604-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA HARDAWAY DMD MS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "HARDAWAY",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-604-1546",
        "authorized_official_credential": "DMD MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909845",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebird Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in West Jefferson, NC
• Providers in West Jefferson, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.