Individual provider Active NPI

Matthew Bart Rowan, D.D.S., M.S.D.

  • Endodontics
  • Merced, CA
National Provider Identifier
1013054188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
40391 Issued in CA
Practice address
3351 North M St.
Suite 210
Merced, CA 95348-2731
Phone
(209) 723-5454
Fax
(209) 723-1952
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 40391 CA Primary

Addresses

Primary practice location

3351 North M St.
Suite 210
Merced, CA 95348-2731

Mailing address

3351 North M St.
Suite 210
Merced, CA 95348
Phone (209) 723-5454

Other identifiers 1

IdentifierTypeStateIssuer
931146928OtherCATAX ID#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013054188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3351 NORTH M ST.",
            "address_2": "SUITE 210",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-723-5454",
            "fax_number": "209-723-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 NORTH M ST.",
            "address_2": "SUITE 210",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482731",
            "telephone_number": "209-723-5454",
            "fax_number": "209-723-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWAN",
        "first_name": "MATTHEW",
        "middle_name": "BART",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "40391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "931146928",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.