Active NPI
Justin D Martin
- Endodontics
- Virginia Beach, VA
National Provider Identifier
1972799567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401008614
- Practice address
- 1200 First Colonial Rd
Suite #201
Virginia Beach, VA 23454-2207 - Phone
- (757) 333-3399
- Fax
- (757) 333-4946
- NPI assigned
- Sep 18, 2007
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 0401008614 | VA | Primary |
Addresses
Primary practice location
1200 First Colonial Rd
Suite #201
Virginia Beach, VA 23454-2207
Mailing address
1200 First Colonial Rd
Ste #201
Virginia Beach, VA 23454-2207
Phone (757) 333-3399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 15, 2016 through Feb 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401008614 | VA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Justin D Martin DDS PC | Endodontics | 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.
-
- Endodontics
- Virginia Beach, VA
- NPI 1184749822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190073600000",
"number": "1972799567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 FIRST COLONIAL RD",
"address_2": "STE #201",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234542207",
"telephone_number": "757-333-3399",
"fax_number": "757-333-4946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 FIRST COLONIAL RD",
"address_2": "SUITE #201",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234542207",
"telephone_number": "757-333-3399",
"fax_number": "757-333-4946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JUSTIN",
"middle_name": "D",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-18",
"last_updated": "2007-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401008614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.