Jack W. Martin
Dentist (Prosthodontics)

Address: 1515 Holcombe Blvd, Houston, TX 77030-4009
Phone: 7137926161

Jack W. Martin (NPI# 1790879765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1790879765
Entity Type Individual
Full Name Jack W. Martin
Credential D.D.S.
Gender Male
Practice Address 1515 Holcombe Blvd
Houston
TX 77030-4009
Practice Telephone 7137926161
Mailing Address Po Box 4439
Houston
TX 77210-4439
Mailing Telephone 7137922991
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-10-03
Last Update Date 2010-11-09

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1223P0700X Dentist · Prosthodontics Dental Providers 11726 TX

Other Provider Identifier

State Identifier Issuer Type Code
TX 800349 OTHER BCBS
TX 111134601 MEDICAID

Other Providers JACK MARTIN

NPI Name Taxonomy Address Enumeration
1073707998 Jack Frederick Martin Sr. Orthopaedic Surgery 1220 Aspen Way, Jack F Martin Md, Petoskey, MI 49770 2007-09-04
1700915279 Jack Kennard Martin Chiropractor 2422 Jolly Rd Ste 100, Okemos, MI 48864-3686 2007-03-02
1003914342 Jack Richard Martin Chiropractor 1601 East Main Street, Suite 1b, St Charles, IL 60174 2006-09-20
1942206214 Jack L Martin Internal Medicine 18615 Tuscany Stone, Suite 170, San Antonio, TX 78258-3498 2005-06-22
1255574521 Jack Robert Martin Psychologist 1300 National Dr, Suite 170, Sacramento, CA 95834-1947 2009-04-15
1831309269 Jack Martin Counselor 5934 S Staples St, Suite 210, Corpus Christi, TX 78413-3842 2007-05-23
1932159878 Jack T. Martin Radiology 4518 Union Deposit Rd, Harrisburg, PA 17111-2910 2006-05-11

Physician Overview

NPI 1790879765
PAC ID by PECOS 0143412742
Professional Enrollment ID I20101013001090
Full Name Jack W Martin
Organization Legal Name PHYSICIANS REFERRAL SERVICE
Phone Number 7135632772
Gender M
Medical School UNIVERSITY OF TEXAS, HOUSTON DENTAL BRANCH
Graduation Year 1978
Primary Specialty ORAL SURGERY
Secondary Specialties MAXILLOFACIAL SURGERY
Group Practice PAC ID 7911801410
Number of Group Practice Members 1834
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
450076 THE UNIVERSITY OF TEXAS M.D. ANDERSON CANCER CENTER

Office Location

Street Address 1515 HOLCOMBE BLVD
City HOUSTON
State TX
Zip Code 77030-4009

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932102126 Najat Daw Bitar Pediatrics 1515 Holcombe Blvd, Houston, TX 77030-4009 2005-05-23
1841859493 Christopher Van Bui Physician Assistant 1515 Holcombe Blvd, Houston, TX 77030-4009 2019-06-07
1336707470 Margarita Tovbin Nurse Practitioner 1515 Holcombe Blvd, Houston, TX 77030-4000 2019-06-04
1629636972 Nicole Gourmelon Physician Assistant 1515 Holcombe Blvd, Houston, TX 77030-4000 2019-06-02
1447817218 Baher Elgohari Student in an Organized Health Care Education/Training Program 1515 Holcombe Blvd, Houston, TX 77030-4000 2019-05-28
1295392363 Ethan Yiyang Lin Student in an Organized Health Care Education/Training Program 1515 Holcombe Blvd, Houston, TX 77030-4000 2019-05-23
1720645054 Caroline Wesonga Nurse Practitioner 1515 Holcombe Blvd, Houston, TX 77030-4000 2019-05-22
1811554025 Audrey Chen Hartnett Nurse Practitioner 1515 Holcombe Blvd, Houston, TX 77030-4009 2019-05-22
1457918765 Marah Tamika Cornelius Nurse Practitioner 1515 Holcombe Blvd, Houston, TX 77030-4000 2019-05-22
1053978692 Shikha Narang Gupta Nurse Practitioner 1515 Holcombe Blvd, Houston, TX 77030-4009 2019-05-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104484393 Marwa Zaid Student in an Organized Health Care Education/Training Program 1400 Pressler St, Houston, Houston, TX 77030 2019-06-03
1881251239 Andrea Marie Costello Obstetrics & Gynecology Gme, Attn: Dottie Mersinger, 6670 Bertner Ave., R2-216, Houston, TX 77030 2019-05-21
1235795717 Rida Salman Student in an Organized Health Care Education/Training Program One Baylor Plaza - Bcm620, Houston, TX 77030 2019-05-10
1497319685 Huan Yang Student in an Organized Health Care Education/Training Program 2430 Dorrington St Unit A, Houston, TX 77030 2019-04-24
1760940753 Charles Patrick Clark Physician Assistant 6621 Fannin St, Houston, Houston, TX 77030 2019-03-08
1942773601 Zamakan Durable Medical Equipment & Medical Supplies 2236 W. Holcombe Blvd, Unit 12401, Houston, TX 77030 2019-01-05
1518449701 Kenton Lee Rommens Surgery 6400 Fannin St. Suite 2850, Houston, TX 77030 2018-09-04
1700366176 Vicki Lynn Waters Physician Assistant One Baylor Plaza, Ms: Bcm115, Debakey Bldg., Room M108, Houston, TX 77030 2018-08-15
1659858249 Caitlin Mallory Clark Psychologist Michael E. Debakey Va Medical Center, 2002 Holcombe Blvd, Houston, TX 77030 2018-07-26
1649756800 Eva Rajha Emergency Medicine 1400 Pressler Street, Houston, TX 77030 2018-07-11
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Taxonomy Information

Taxonomy Code 1223P0700X
Grouping Dental Providers
Classification Dentist
Specialization Prosthodontics

Taxonomy Definition

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871004804 Khayri Aljabi Dentist 6516 Westheimer Rd Ste J, Houston, TX 77057-5139 2017-10-17
1841709367 Cham Dental Clinic Dentist 2656 S Loop W Ste 220, Houston, TX 77054-2798 2017-09-27
1598111676 Gabriel Fernando Sader Dentist 6423 Saragosa Crossing Ln, Houston, TX 77066-3398 2016-05-09
1407287451 Bk Dental Management Pa Dentist 7700 Fulton St, Houston, TX 77022-3638 2013-12-02
1225469273 Bk Dental Management Pa Dentist 7442 Park Place Blvd, Houston, TX 77087-4442 2013-12-02
1831538677 Johanna Yepez Dentist 927 Studewood St Ste 300, Houston, TX 77008-1579 2013-06-14
1013290865 The Dentists At 650 Heights Pllc Dentist 650 Heights Blvd., Houston, TX 77007 2011-09-27
1760777437 Aurelija Galanis Dentist 2902 N Shepherd Dr, Suite C, Houston, TX 77008-2293 2011-06-10
1558660662 Nathan James Pettit Dentist 7505 S Main, Suite 210, Houston, TX 77030 2011-03-15
1073844130 S&s Aldine Dental, PC Dentist 10407 North Fwy, Suite B, Houston, TX 77037-1136 2010-01-28
Find all providers in HOUSTON

Competitor

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City HOUSTON
Zip Code 77030

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Dataset Information

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.

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