Phillip Ronald Martin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN15702 Issued in FL

Practice address

844 S Marion Ave
Lake City, FL 32025-5855

Phone

(386) 752-8531

Fax

(386) 752-7681

NPI assigned

Feb 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lake City Dental

  • General Practice Dentistry
  • Lake City, FL
  • NPI 1578840245
  NPD (past)

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1982900908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255855",
            "telephone_number": "386-752-8531",
            "fax_number": "386-752-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255855",
            "telephone_number": "386-752-8531",
            "fax_number": "386-752-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PHILLIP",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Kids Dental Health Team of Lake City, PLLC
• Andrew P Martin, DMD
• Angel Priscilla Martin
• Celia Susan Martin, D.M.D
• Michaelnisha R Martin
• Juan Martinez Estrada, MD
• Nicholas Martino, APRN
• Taylor Nicole Martino, PHARMD
• Emily E Masten
• Ceili Masterson, DMD

• General Practice Dentistry in Lake City, FL
• Providers in Lake City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.