Individual provider Active NPI

Eugene Matesi, DDS

  • General Practice Dentistry
  • Anthem, AZ
National Provider Identifier
1013979111
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2010 Issued in AZ
Practice address
4205 W Anthem Way
Ste #106
Anthem, AZ 85086-0444
Phone
(623) 551-5250
Fax
(623) 551-1039
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2010 AZ Primary

Addresses

Primary practice location

4205 W Anthem Way
Ste #106
Anthem, AZ 85086-0444

Mailing address

4205 W Anthem Way
Ste #106
Anthem, AZ 85086-0444
Phone (623) 551-5250

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
2010AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1013979111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 W ANTHEM WAY",
            "address_2": "STE #106",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850860444",
            "telephone_number": "623-551-5250",
            "fax_number": "623-551-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 W ANTHEM WAY",
            "address_2": "STE #106",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850860444",
            "telephone_number": "623-551-5250",
            "fax_number": "623-551-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATESI",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthem, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.