Active NPI
Mark Vanmarter, DDS
- General Practice Dentistry
- Fulton, NY
National Provider Identifier
1821748377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 063447
- Practice address
- 34 S 1St St
Fulton, NY 13069-1869 - Phone
- (315) 592-4141
- NPI assigned
- Mar 27, 2022
- 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 | 063447 | NY | Primary |
Addresses
Primary practice location
34 S 1St St
Fulton, NY 13069-1869
Mailing address
653 S Main St
Central Square, NY 13036-9105
Phone (315) 668-6261
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 |
|---|---|---|---|
| 063447 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Square Smiles Dentistry | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Central Square, NY
- NPI 1851896567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1821748377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "653 S MAIN ST",
"city": "CENTRAL SQUARE",
"state": "NY",
"postal_code": "130369105",
"telephone_number": "315-668-6261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 S 1ST ST",
"city": "FULTON",
"state": "NY",
"postal_code": "130691869",
"telephone_number": "315-592-4141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANMARTER",
"first_name": "MARK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-27",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "063447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fulton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.