Mathew Owens, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015015 Issued in GA

Practice address

87 S Burnt Mill Rd
La Fayette, GA 30728-4263

Phone

(706) 620-4494

Fax

(706) 657-2958

NPI assigned

Jul 10, 2015

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1043694912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13570 N MAIN ST",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307522012",
            "telephone_number": "706-956-2665",
            "fax_number": "706-657-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 S BURNT MILL RD",
            "city": "LA FAYETTE",
            "state": "GA",
            "postal_code": "307284263",
            "telephone_number": "706-620-4494",
            "fax_number": "706-657-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168798A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168798B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168798C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Ann Novak, N.P.
• Kelly O'Bryant, LMSW
• Deedee Oliver
• Mary E Ortwein, R.D.
• Arial Osborn
• Matthew Parker, DPT
• Kalindi K Patel, PHYSICAL THERAPIST
• Performance Physical Therapy & Sports Medicine Inc
• Physical Therapy Plus, LLC (LaFayette Physical Therapy)
• Primary Health Care Center of Dade, Inc.

• General Practice Dentistry in La Fayette, GA
• Providers in La Fayette, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.