MARTIN, DDS PLLC (NPI# 1760810444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760810444 |
| Entity Type | Organization |
| Organization Name | MARTIN, DDS PLLC |
| Other Organization Name | YOUNG SMILES WV |
| Practice Address |
140 7th Ave South Charlestown WV 25303 |
| Practice Telephone | 3043424422 |
| Practice Fax Number | 3044004986 |
| Mailing Telephone | 3043424422 |
| Mailing Fax Number | 3044004986 |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2020-06-17 |
| Authorized Official Name | MR. JARREL R MARTIN II (MEMBER/OWNER) |
| Authorized Official Telephone | 3044190125 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 3945 | WV | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3827 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810000582 | 05 |
| Other Name | Type Code |
|---|---|
| Young Smiles WV | Other Name - Individual/Organization |
| Street Address |
140 7TH AVE |
| City | SOUTH CHARLESTOWN |
| State | WV |
| Zip Code | 25303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588009 | Shirley Ann Womack | Technician | 131 6th Ave. Apt.#305, South Charleston, WV 25303 | 2020-11-04 |
| 1407350713 | Special Touch Nursing Services, Inc. | In Home Supportive Care | 325 4th Ave Ste 1, South Charleston, WV 25303 | 2018-03-21 |
| 1003213471 | Neveah Health & Wellness Center, Pllc | Family Medicine | 538 3rd Avenue, South Charleston, WV 25303 | 2014-12-01 |
| 1053594267 | Mary Elizabeth Taylor | Specialist | 117 7th Avenue, South Charleston, WV 25303 | 2007-12-11 |
| 1093937633 | Loved Ones In Home Care | Home Health | 144 7th Ave, South Charleston, WV 25303 | 2007-05-03 |
| 1477643302 | William V. Jordan | Chiropractor | 411 D. Street, South Charleston, WV 25303 | 2006-10-13 |
| 1699864793 | Debora Lynn Wells | Counselor | 1418a Maccorkle Avenue Sw, Charleston, WV 25303 | 2006-10-12 |
| 1457443830 | Special Touch Nursing Services, Inc. | Home Health | 325 Fourth Ave, Suite #1, South Charleston, WV 25303 | 2006-09-29 |
| 1275625964 | Bryan Scott Eder | Dentist | 71 Maccorkle Ave Sw, South Charleston, WV 25303 | 2006-09-29 |
| 1730101569 | John Bruce Todd | Psychologist | 1418a Maccorkle Ave Sw, Charleston, WV 25303 | 2006-07-24 |
| Find all providers in zip 25303 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861022733 | Erin H Branham Dds Pllc | Dentist | 225 College Pkwy Ste 201, Parkersburg, WV 26104-7655 | 2020-01-20 |
| 1154713246 | Dr. Cynthia D. Parks Dds, Pllc | Dentist | 601 Venture Dr, Suite 200, Morgantown, WV 26508-7310 | 2015-02-26 |
| 1124452644 | Katie Steele Dds Pllc, Steele Pediatric Dentistry | Dentist | 204 Kruger St Ste 1, Wheeling, WV 26003-5165 | 2013-09-03 |
| 1487948741 | Eric J Bailey | Dentist | 3659 Teays Valley Rd, Suite 100, Hurricane, WV 25526-9701 | 2011-06-04 |
| 1215127881 | Erin Hudgins Branham | Dentist | 414 Alpine St, Mineral Wells, WV 26150-3015 | 2007-07-30 |
| 1922208867 | Rebecca Johnson Kucera | Dentist | 1489 N Jefferson St, Lewisburg, WV 24901-1187 | 2007-07-19 |
| 1760501001 | Tracy L. Wilkerson, Dds, Pllc | Dentist | 1400 Kanawha Blvd E, Charleston, WV 25301-3002 | 2007-03-28 |
| 1639215684 | John Patrick Martin | Dentist | 3659 Teays Valley Road, Suite 100, Hurricane, WV 25526-9701 | 2007-01-29 |
| 1306912258 | Seyed Moe Momen | Dentist | 9 Chenoweth Drive, Bridgeport, WV 26330 | 2006-11-24 |
| 1386756054 | Cynthia Denise Parks | Dentist | 7000 Coomb's Farm Drive, Suite 102, Morgantown, WV 26508 | 2006-08-31 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTOWN |
| Zip Code | 25303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.