Individual provider Active NPI

William Frederick Martsch, DDS

  • General Practice Dentistry
  • Fruitland, ID
National Provider Identifier
1912075839
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3076 Issued in ID
Practice address
315 N. Whitley
Fruitland, ID 83619
Phone
(208) 452-2722
Fax
(208) 642-8941
NPI assigned
Nov 30, 2006
Last updated
Nov 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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 D3076 ID Primary

Addresses

Primary practice location

315 N. Whitley
Fruitland, ID 83619

Mailing address

315 N. Whitley
Fruitland, ID 83619
Phone (208) 452-2722

Other identifiers 1

IdentifierTypeStateIssuer
001016600MedicaidID

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
D3076IDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1912075839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N. WHITLEY",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "83619",
            "telephone_number": "208-452-2722",
            "fax_number": "208-642-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N. WHITLEY",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "83619",
            "telephone_number": "208-452-2722",
            "fax_number": "208-642-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTSCH",
        "first_name": "WILLIAM",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001016600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.