Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902884752 Individual Practitioner Female Practitioner

Dr. Charissa Michelle Martin , DMD

Dentist - General Practice • Boulder, MT

Professional Overview & Biography Verified Profile Summary

Dr. Charissa Martin, DMD is a registered healthcare professional specializing in Dentist - General Practice in Boulder, MT. Practice services are available at 211 NORTH MAIN STREET under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

211 North Main Street

Boulder, MT 59631

Telephone 4062254222
Fax 4062254222
Associated Practice Facility / Clinic
🏢 Elkhorn Family Dental, Llc Facility NPI 1740546100

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Boulder, MT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Boulder, MT (489 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MT 2386

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License OR D8602

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
5901637 (NC)
Commercial Insurance / Payer ID Nc Dental License #
8098 (NC)
Commercial Insurance / Payer ID Blue Cross Blue Shield #
9022M (NC)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2023

Dentist (License #2386 in MT)

NPI Profile Active March 21, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location March 21, 2012

Registered at 211 NORTH MAIN STREET, BOULDER, MT 59631 (Tel: 4062254222)

📍
Updated Business Mailing Address March 21, 2012

Registered at 211 NORTH MAIN STREET, PO BOX 512, BOULDER, MT 59631 (Tel: 4062254222)

👤
Provider Name / Credentials Updated March 21, 2012

Recorded as CHARISSA MARTIN, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 21, 2012

Dentist (License #2386 in MT)

🟢
Initial NPI Registration & Enumeration January 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902884752
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 03, 2006
Last Update: March 07, 2023
Sole Proprietor: No

Mailing Address

211 North Main Street, Po Box 512

Boulder, MT 59631

Phone: 4062254222

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.