Active NPI
Martin Borrok Jr., DMD
- Dentist
- Kirksville, MO
National Provider Identifier
1881043628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11521
- Practice address
- 1310 Crown Dr
Kirksville, MO 63501-2526 - Phone
- (660) 341-4236
- NPI assigned
- Jun 10, 2016
- Last updated
- Jun 10, 2016
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 11521 | MO | Primary |
Addresses
Primary practice location
1310 Crown Dr
Kirksville, MO 63501-2526
Mailing address
16982 State Highway DD
Novinger, MO 63559-2607
Phone (660) 341-4236
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 |
|---|---|---|---|
| 11521 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1881043628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16982 STATE HIGHWAY DD",
"city": "NOVINGER",
"state": "MO",
"postal_code": "635592607",
"telephone_number": "660-341-4236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 CROWN DR",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635012526",
"telephone_number": "660-341-4236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORROK",
"first_name": "MARTIN",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "11521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.