Active NPI
Jaclyn Sabina Martin, DDS MS
- Dentist
- Janesville, WI
National Provider Identifier
1962532879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5837
- Practice address
- 2726 Woodlane Dr
Janesville, WI 53545 - Phone
- (608) 756-3149
- Fax
- (608) 756-0479
- NPI assigned
- Mar 7, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 5837 | WI | Primary |
Addresses
Primary practice location
2726 Woodlane Dr
Janesville, WI 53545
Mailing address
2726 Woodlane Dr
Janesville, WI 53545
Phone (608) 756-3149
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5837 | WI | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gregg R Dickinson DDS SC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Janesville, WI
- NPI 1205955036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962532879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2726 WOODLANE DR",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "53545",
"telephone_number": "608-756-3149",
"fax_number": "608-756-0479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2726 WOODLANE DR",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "53545",
"telephone_number": "608-756-3149",
"fax_number": "608-756-0479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JACLYN",
"middle_name": "SABINA",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "5837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.