Shane Matt, DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHANE MATT, DDS PLLC

Doing business as

Authentic Smiles

Practice address

211 San Antonio St
Austin, TX 78701-4063

Phone

(512) 330-9403

Fax

(512) 373-3408

NPI assigned

Sep 22, 2014

Last updated

Sep 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shane Eden Matt, DDSNPI 1912121849

Title

Owner

Phone

(512) 330-9403

Specialties & licenses 1

Addresses

Other names 1

• Authentic Smiles Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shane Matt, DDS

  • General Practice Dentistry
  • Austin, TX
  • NPI 1912121849
  NPD (past) Authorized official

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1033511084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SAN ANTONIO ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787014063",
            "telephone_number": "512-330-9403",
            "fax_number": "512-373-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAN ANTONIO ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787014063",
            "telephone_number": "512-330-9403",
            "fax_number": "512-373-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE MATT, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "MATT",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "EDEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-330-9403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Authentic Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Shanahan, APRN, FNP-C
• Kristin Shanahan, LPC
• Shanan Chiropractic
• Shane Edward Keller MD PA (Parkway Primary Care)
• Shane Istre Dental Associates (Smile Center PA)
• James Howard Shane, M.D.
• Jonathan Ryan Shaner, D.C.
• Sarah Alexis Laurielle Shaney, LCSW
• Courtney Safron Shanitkvich, RD
• Hayley Ellen Shank, OTR, OTD

• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.