Kevin Douglas Martello, D.M.D
Individual provider Active NPI General Practice Dentistry · Haughton, LA
NPI 1801001813 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801001813
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4201 (LA)
- Practice address
- 2114 Highway 80
Haughton, LA 71037-9497 - Phone
- (318) 949-8344
- Fax
- (318) 949-8344
- NPI assigned
- May 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4201 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brittany G House a Professional Corporation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4201 | LA | Yes |
Addresses
Primary practice location
2114 Highway 80
Haughton, LA 71037-9497
Mailing address
5 Sterling Ranch Rd N
Haughton, LA 71037-8535
Phone (318) 949-2074
Other providers in Haughton, LA
- Louisiana CVS Pharmacy, LLC
- Lundell Enterprises Inc.
- Candice Ann Macdaniels
- Manna Horse
- Tomika Marshall
- Cassanda Howell Maxwell
- James Michael McCormick
- Ashlei McDonald
- Phillip Anthony McKee Jr.
- Lundell Lee McKittrick
All providers in Haughton, LA · General Practice Dentistry in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.