Active NPI
David Rodney Matthew
- General Practice Dentistry
- Vineyard Haven, MA
National Provider Identifier
1013593433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN20741
- Practice address
- 60 Lagoon Pond Rd
Vineyard Haven, MA 02568-5511 - Phone
- (508) 693-5068
- NPI assigned
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN20741 | MA | Primary |
Addresses
Primary practice location
60 Lagoon Pond Rd
Vineyard Haven, MA 02568-5511
Mailing address
PO Box 1349
Vineyard Haven, MA 02568-0905
Phone (508) 693-5068
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN20741 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616544000000",
"number": "1013593433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1349",
"city": "VINEYARD HAVEN",
"state": "MA",
"postal_code": "025680905",
"telephone_number": "508-693-5068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 LAGOON POND RD",
"city": "VINEYARD HAVEN",
"state": "MA",
"postal_code": "025685511",
"telephone_number": "508-693-5068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEW",
"first_name": "DAVID",
"middle_name": "RODNEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-24",
"last_updated": "2021-03-24",
"certification_date": "2021-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN20741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vineyard Haven, MA
- Martha'S Vineyard Endodontics, P.C.
- Martha'S Vineyard School District
- Martha'Svinyard Community Services
- Marthas Vineyard Community Services Inc.
- Marthas Vineyard Eye Care Inc
- Dominic J Maxwell, MD
- Kelly Merrill McCarron
- Michelle McCrumb, D.P.M.
- Mary Ellen McElroy, MA, LMHC
- Courtenay Winfield McKinley-Griffin, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.