Matthew William Hatzke, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

63671 Issued in CA

Practice address

1300 W Lodi Ave Ste N
Lodi, CA 95242-3038

Phone

(209) 368-1909

NPI assigned

Jul 21, 2014

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

Medicare fee-for-service enrollment

Enrolled in CA

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

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.

• SP Endodontics Partnershiop

  • Endodontics
  • Lodi, CA
  • NPI 1518566702
  NPD Authorized official
• SP Stockton Endodontics Partnership

  • Endodontics
  • Stockton, CA
  • NPI 1811731169
  NPD Authorized official
• Mario J Cordero-Pangrazio, DMD, Inc

  • Dental Clinic/Center
  • San Jose, CA
  • NPI 1851019509
  NPD (past)
• Martin R. Hatzke, DDS, Inc.

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1669584355
  NPD (past)

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1013324102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE STE N",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423038",
            "telephone_number": "209-368-1909",
            "fax_number": "209-368-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE STE N",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423038",
            "telephone_number": "209-368-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATZKE",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2021-05-11",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Harris, MA, ED.S.
• Frank M Hartwick, MD
• Harvey Hashimoto MD Inc
• Harvey Hashimoto, MD
• Malak Ahmad Hassan
• Karen Hauben
• Kimberly Lynn Hauner, NP
• Hayashi Dental Corporation
• Hayes Chiropractic Inc
• Michael Charles Hayes, D.C.

• Dentist in Lodi, CA
• Providers in Lodi, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.