Mathias Stephen Fallis, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

102159 Issued in CA

Practice address

500 S Sepulveda Blvd Ste 216
Manhattan Beach, CA 90266-6976

Phone

(424) 587-0472

NPI assigned

Aug 25, 2017

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

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1043737430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S SEPULVEDA BLVD STE 216",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S SEPULVEDA BLVD STE 216",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666976",
            "telephone_number": "424-587-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLIS",
        "first_name": "MATHIAS",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-25",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "102159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simin Eshtehardi, LMFT
• Adrian Esparza, M.S
• Maria Etchepare, NP
• Executive Linguist Agency, Inc
• Eye Sight Optician, Inc.
• Kelsey Anne Fallon
• Carlo Miguel Farrales, BS
• Keith Simon Feder, M.D.
• Rachel Fein-Liston, OTR/L
• Danielle Fester, DPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.