Matthew P. Durham, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

290107668 Issued in MI

Practice address

2700 5 Mile Rd NE
Ste. #201
Grand Rapids, MI 49525-1710

Phone

(616) 361-1727

Fax

(616) 361-1455

NPI assigned

Jan 23, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Durham & Mehling DDS PC

  • Dentist
  • Grand Rapids, MI
  • NPI 1023097474
  Medicare reassignment NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1003960436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 5 MILE NERD 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256516",
            "telephone_number": "616-361-1727",
            "fax_number": "616-361-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 5 MILE RD NE",
            "address_2": "STE. #201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251710",
            "telephone_number": "616-361-1727",
            "fax_number": "616-361-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "MATTHEW",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "290107668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4361190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bailey Denise Elaine Duren
• Izabel Durey
• Andrew Durfee
• Nicole Durga, DPT
• Durham & Mehling DDS PC
• Todd D. Durham, M.D.
• Emily T Durkin, M.D.
• Luke Thomas Durling, MD
• Amber Duron
• Lindsey Kaitlyn Durowoju, MD

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.