Jean a Martin DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6435 Issued in OR

Legal business name

JEAN A MARTIN DDS PC

Practice address

150 NE 3Rd Ave
Canby, OR 97013-3712

Phone

(503) 266-2629

Fax

(503) 266-2625

NPI assigned

Mar 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kim Denise Churchwell

Title

Office Manager

Phone

(503) 266-2629

Specialties & licenses 1

Addresses

Other names 1

• Canby Smiles Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean Allen Martin, DDS

  • General Practice Dentistry
  • Canby, OR
  • NPI 1407840887
  NPD (past)
• Rita Patterson, DMD

  • General Practice Dentistry
  • Canby, OR
  • NPI 1740214238
  NPD (past)
• Joshua L. Wieland, DMD

  • Dentist
  • Canby, OR
  • NPI 1437301595

  General Practice

  NPD (past)

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1962777532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NE 3RD AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133712",
            "telephone_number": "503-266-2629",
            "fax_number": "503-266-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NE 3RD AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133712",
            "telephone_number": "503-266-2629",
            "fax_number": "503-266-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN A MARTIN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "CHURCHWELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-266-2629",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "6435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canby Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mikaila Horan, OTR/L
• Christina L Hostetler
• Daniel L Hughson, MD
• Erika Irwin, ATC
• JB Sowles
• Abigail Joffe-Aalto
• Alison Johnson, LCSW
• Karla Beth Johnson, LMT
• Kevin Brooks Johnson, D.M.D.
• Sophia H Jones, PSS

• General Practice Dentistry in Canby, OR
• Providers in Canby, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.