Individual provider Active NPI

Martin A Segal, DMD

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1861534679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5457 Issued in KY
Practice address
300 Middletown Park PL Ste a
Louisville, KY 40243-2513
Phone
(502) 245-8666
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5457 KY Primary

Addresses

Primary practice location

300 Middletown Park PL Ste a
Louisville, KY 40243-2513

Mailing address

300 Middletown Park PL Ste a
Louisville, KY 40243-2513
Phone (502) 245-8666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170127001038 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799965810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5457KYMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Louisville Oral Surgery and Dental Implants PLC PastSince Oct 6, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861534679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MIDDLETOWN PARK PL STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432513",
            "telephone_number": "502-245-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MIDDLETOWN PARK PL STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432513",
            "telephone_number": "502-245-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "MARTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "5457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.