Samuel Colombo Martino, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4641 Issued in WV

Practice address

1402 Buckhannon Pike
Nutter Fort, WV 26301-4494

Phone

(304) 305-4376

NPI assigned

Jun 14, 2023

Last updated

Jun 14, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1790469294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 STANLEY AVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263013127",
            "telephone_number": "304-203-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BUCKHANNON PIKE",
            "city": "NUTTER FORT",
            "state": "WV",
            "postal_code": "263014494",
            "telephone_number": "304-305-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "SAMUEL",
        "middle_name": "COLOMBO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James M Lackey, PA-C
• Samantha Lackey
• Lorri R Ledsome
• Amy Lusk, PHARMD
• Matthew A Madrid, P.T.
• Emily Moore, DPT
• Amanda Murphy
• Physician's First Care
• Pinti Physical Therapy & Sports Medicine
• Mark A Pinti, PT

• General Practice Dentistry in Nutter Fort, WV
• Providers in Nutter Fort, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.