Active NPI
Stephen William Martinkovic, DDS
- General Practice Dentistry
- Fairfield, OH
National Provider Identifier
1871658021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14973
- Practice address
- 1115 Hicks Blvd Ste 3
Fairfield, OH 45014-2867 - Phone
- (513) 829-8844
- Fax
- (513) 829-8845
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 14973 | OH | Primary |
Addresses
Primary practice location
1115 Hicks Blvd Ste 3
Fairfield, OH 45014-2867
Mailing address
1115 Hicks Blvd Ste 3
Fairfield, OH 45014-2867
Phone (513) 829-8844
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 |
|---|---|---|---|
| 14973 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1871658021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 HICKS BLVD STE 3",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450142867",
"telephone_number": "513-829-8844",
"fax_number": "513-829-8845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 HICKS BLVD STE 3",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450142867",
"telephone_number": "513-829-8844",
"fax_number": "513-829-8845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINKOVIC",
"first_name": "STEPHEN",
"middle_name": "WILLIAM",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "14973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.