Matthew J Allen, DDS
Individual provider Active NPI General Practice Dentistry · Pooler, GA
NPI 1053405290 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1053405290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 012627 (GA)
- Practice address
- 1000 Towne Center Blvd Ste 101
Pooler, GA 31322-4508 - Phone
- (912) 748-8585
- Fax
- (912) 748-8505
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012627 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Satilla Family Smiles LLC | General Practice | Current | Accepting new patients |
| Lexington Family Smiles | General Practice | Current | Accepting new patients |
| First City Dental LLC | General Practice | Current | Accepting new patients |
Locations
1000 Towne Center Blvd
Ste 101
Pooler, GA 31322
Phone (912) 385-4134
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 012627 | GA | Yes |
Addresses
Primary practice location
1000 Towne Center Blvd Ste 101
Pooler, GA 31322-4508
Mailing address
1000 Towne Center Blvd Ste 101
Pooler, GA 31322-4508
Phone (912) 748-8585
Other providers in Pooler, GA
- James Ahern
- Shamshad Ahmed
- Carina Ashok Akshar
- Christopher Robin Alden
- Alexander Bannout DDS, PC
- Tamia Allen
- Imani Alston
- Altamaha DME, Inc
- Miracle Danyelle Alvin
- American Oncology Partners, P.a.
All providers in Pooler, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.