Individual provider Active NPI

Corwin Dean Martin, MD DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
National Provider Identifier
1760590509
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
D05182 Issued in AZ
Practice address
9450 E Ironwood Square Dr
Scottsdale, AZ 85258-4570
Phone
(480) 551-0581
Fax
(480) 551-0585
NPI assigned
Aug 29, 2006
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D5182 AZ
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 18135 TX
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X D05182 AZ Primary
Plastic Surgery Physician 208200000X 29085 AZ
Plastic Surgery Physician 208200000X L0398 TX

Addresses

Primary practice location

9450 E Ironwood Square Dr
Scottsdale, AZ 85258-4570

Mailing address

9450 E Ironwood Square Dr
Scottsdale, AZ 85258-4570
Phone (480) 551-0581

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D5182AZMDOral and Maxillofacial Surgery (Dentist)
18135TXMDOral and Maxillofacial Surgery (Dentist)
D05182AZMDOral & Maxillofacial Surgery (D.M.D.)
29085AZMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corwin D Martin Oral and Maxillofacial Surgery CurrentSince Jul 31, 2023 Accepting new patients
Impressions at Casa Grande PLC Past Accepting new patients
North Texas Dental Specialists, P.C. Past Accepting new patients

Locations

9450 E Ironwood Square Dr
Scottsdale, AZ 85258
Phone (480) 551-0581

9450 E Ironwood Square Dr
Ste 100
Scottsdale, AZ 85258
Phone (480) 551-0581

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1760590509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 E IRONWOOD SQUARE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584570",
            "telephone_number": "480-551-0581",
            "fax_number": "480-551-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 E IRONWOOD SQUARE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584570",
            "telephone_number": "480-551-0581",
            "fax_number": "480-551-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CORWIN",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "MD DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D5182",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "18135",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "D05182",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "29085",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "L0398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.