Active NPI
William Frederick Martsch, DDS
- General Practice Dentistry
- Fruitland, ID
National Provider Identifier
1912075839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D3076
- 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, 2012
- 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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001016600 | Medicaid | ID |
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 |
|---|---|---|---|
| D3076 | ID | MD | General 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.