Individual provider Active NPI

Georges Paul Martin, D.M.D.

  • General Practice Dentistry
  • Havertown, PA
National Provider Identifier
1891964201
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS025838L Issued in PA
Practice address
31 S Eagle Rd
Suite 100
Havertown, PA 19083-3340
Phone
(610) 446-9496
Fax
(610) 449-0449
NPI assigned
Feb 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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 DS025838L PA Primary

Addresses

Primary practice location

31 S Eagle Rd
Suite 100
Havertown, PA 19083-3340

Mailing address

31 S Eagle Rd
Suite 100
Havertown, PA 19083-3340
Phone (610) 446-9496

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

LicenseStateTypeSpecialty
DS025838LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1891964201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 S EAGLE RD",
            "address_2": "SUITE 100",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833340",
            "telephone_number": "610-446-9496",
            "fax_number": "610-449-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S EAGLE RD",
            "address_2": "SUITE 100",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833340",
            "telephone_number": "610-446-9496",
            "fax_number": "610-449-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GEORGES",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS025838L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.

Verify at the official NPI Registry.