Brent Leonard Martin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8461 Issued in MN

Practice address

8380 City Centre Dr
Suite 120
Woodbury, MN 55125-5304

Phone

(651) 714-1642

Fax

(651) 714-4415

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Marc Montgomery DDS PA

  • General Practice Dentistry
  • Woodbury, MN
  • NPI 1417825563
  NPD (past)
• Marc Montgomery Dental GPS PLLC

  • General Practice Dentistry
  • Woodbury, MN
  • NPI 1407701253
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1891743811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 CITY CENTRE DR",
            "address_2": "SUITE 120",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255304",
            "telephone_number": "651-714-1642",
            "fax_number": "651-714-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 CITY CENTRE DR",
            "address_2": "SUITE 120",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255304",
            "telephone_number": "651-714-1642",
            "fax_number": "651-714-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRENT",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Your Home Health Care LLC
• Rachel Markoe, MA
• Maren Elizabeth Marks, PTA
• Malachi Japheth Mart, D.C.
• Alisha Lynn Martell, CCC-SLP
• Jonathan Martin
• Karen Louise Martin, CNS, APRN-BC
• Olivia Martin
• Angie Rachelle Marty, LADC
• Hailey Jolene Marx

• General Practice Dentistry in Woodbury, MN
• Providers in Woodbury, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.