Active NPI
Gregory Lynn Martin, D.D.S.
- General Practice Dentistry
- Magnolia, AR
National Provider Identifier
1750720694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3947
- Practice address
- 301 E Stadium
Magnolia, AR 71753-2034 - Phone
- (870) 901-7645
- Fax
- (870) 234-2030
- NPI assigned
- Jun 24, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3947 | AR | Primary |
Addresses
Primary practice location
301 E Stadium
Magnolia, AR 71753-2034
Mailing address
301 E Stadium
Magnolia, AR 71753-2034
Phone (870) 901-7645
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 |
|---|---|---|---|
| 3947 | AR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372032000000",
"number": "1750720694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E STADIUM",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "717532034",
"telephone_number": "870-901-7645",
"fax_number": "870-234-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E STADIUM",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "717532034",
"telephone_number": "870-901-7645",
"fax_number": "870-234-2030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "GREGORY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-24",
"last_updated": "2013-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "3947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Magnolia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.