MEDICARE: KENDRA MARTIN DERMATOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1770421315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENDRA MARTIN DERMATOLOGY

Provider Business Mailing Address
First Line	:	22 MILL ST STE 310
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4744
Country	:	US
Telephone Number	:	781-643-0500
Fax Number	:	781-648-8509

Provider Business Practice Location Address
First Line	:	22 MILL ST STE 310
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4744
Country	:	US
Telephone Number	:	781-643-0500
Fax Number	:	781-648-8509

Authorized Official
Title or Position	:	DERMATOLOGIST
Name	:	KENDRA MARTIN
Credential	:	MD
Telephone Number	:	781-643-0500

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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