NPIMap

Organization Active NPI

Martin Dentistry PC

  • Dental Clinic/Center
  • Elizabethton, TN
National Provider Identifier
1730757691
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MARTIN DENTISTRY PC
Practice address
417 Hudson Dr
Elizabethton, TN 37643-2881
Phone
(423) 543-4141
NPI assigned
Jun 16, 2021
Organization subpart
Yes
Parent organization
MARTIN DENTISTRY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Rebecca Arnold
Title
Revenue Manager
Phone
(423) 247-8172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

417 Hudson Dr
Elizabethton, TN 37643-2881

Mailing address

417 Hudson Dr
Elizabethton, TN 37643-2881
Phone (423) 543-4141

Other names 1

  • Dr. Jack Holly, DDS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Martin Dentistry PC5 organizations share this tax ID, including this one
Part of
Martin Dentistry PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

417 Hudson Dr
Elizabethton, TN 37643
Phone (423) 543-4141

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1730757691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 HUDSON DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432881",
            "telephone_number": "423-543-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 HUDSON DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432881",
            "telephone_number": "423-543-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN DENTISTRY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARTIN DENTISTRY PC",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "REVENUE MANAGER",
        "authorized_official_telephone_number": "423-247-8172"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Jack Holly, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.