Kevin Mathew Martin, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S2-26 Issued in NV

Practice address

9450 W Russell Rd Ste 102
Las Vegas, NV 89148-5690

Phone

(702) 312-2273

Fax

(702) 312-2276

NPI assigned

Feb 21, 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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NV

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

Locations

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.

• Monica Ponce, DDS, a Professional Corporation

  dba Delicate Dental

  • Dental Clinic/Center
  • Las Vegas, NV
  • NPI 1164050365
  NPD

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1952376295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 W RUSSELL RD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485690",
            "telephone_number": "702-570-3320",
            "fax_number": "702-570-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 W RUSSELL RD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485690",
            "telephone_number": "702-312-2273",
            "fax_number": "702-312-2276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9450 W Russell Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891485690",
            "country_code": "US",
            "telephone_number": "702-570-3320",
            "fax_number": "702-570-3424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KEVIN",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002202729",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gotguns@aol.com",
            "affiliation": "N",
            "endpointDescription": "Gotguns@aol.com",
            "address_1": "9450 W Russell Rd Ste 102",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891485690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gotguns@aol.com",
            "affiliation": "N",
            "endpointDescription": "Gotguns@aol.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Delicate oral surgery",
            "address_1": "9450 W Russell Rd Ste 102",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891485690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen Martin
• Kari Martin
• Kate Elizabeth Martin, MD
• Kelsey Martin
• Kelsey Anne Martin, RN
• Kimberly Martin
• Lakeisha Martin
• Latanya Martin
• Latishia Martin
• Lauren Grace Martin, APRN

• Oral and Maxillofacial Surgery (Dentist) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.