NPIMap

Individual provider Active NPI

Matthew Vogel, DMD

  • General Practice Dentistry
  • Gresham, OR
National Provider Identifier
1013321587
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10891 Issued in OR
Practice address
1201 SE 223Rd Ave Ste 140
Gresham, OR 97030
Phone
(503) 665-8116
NPI assigned
Jun 12, 2014
Last updated
Oct 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D009008 AZ
Student in an Organized Health Care Education/Training Program 390200000X AZ
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X D10891 OR Primary

Addresses

Primary practice location

1201 SE 223Rd Ave Ste 140
Gresham, OR 97030

Mailing address

1201 SE 223Rd Ave Ste 140
Gresham, OR 97030-2576
Phone (503) 665-8116

Other practice location 1

3750 Highway 95
Suite 106
Bullhead City, AZ 86442-8218
Phone (928) 704-2580

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

State licenses

LicenseStateTypeSpecialty
D009008AZMDGeneral Practice Dentistry
D10891ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Dental Professionals, P.C. General Practice Past Accepting new patients
Matthew W. Vogel, DMD, LLC General Practice Past Accepting new patients
Daniel J Ries, DMD, PC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1013321587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SE 223RD AVE STE 140",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302576",
            "telephone_number": "503-665-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SE 223RD AVE STE 140",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-665-8116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3750 Highway 95",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864428218",
            "country_code": "US",
            "telephone_number": "928-704-2580",
            "fax_number": "928-704-2583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOGEL",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009008",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.