Walter Gentry Martin DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WALTER GENTRY MARTIN DDS PLLC

Practice address

2225 E W T Harris Blvd Ste 100
Charlotte, NC 28213-5384

Phone

(704) 494-4050

NPI assigned

Sep 23, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Walter Gentry Martin Sr., DDSNPI 1144585290

Title

Administrator

Phone

(336) 407-7224

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Walter Martin, DDS

  • Dentist
  • Charlotte, NC
  • NPI 1144585290
  NPD Authorized official
• Detra Kashon Brooks, D.D.S.

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1821252958
  NPD (past)

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1861009961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7903 WILBY HOLLOW DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701824",
            "telephone_number": "336-407-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E W T HARRIS BLVD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135384",
            "telephone_number": "704-494-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER GENTRY MARTIN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "GENTRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-407-7224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144585290",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Walsh III, MD
• Steven James Walsh, M.D.
• Sydney Walsh, OD
• Taylor Marie Walsh, PHARMD
• Thomas Declan Walsh, MD
• Katherine Blair Walter, CSAC
• Alexis Walters
• Autumn Franchesca Walters
• Daniel R. Walters, DC
• Dashaun Walters

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.