Individual provider Active NPI

Matthew Gaynier, DDS

  • Dentist
  • Chester, VA
National Provider Identifier
1063906220
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401416068 Issued in VA
Practice address
4516 W Hundred Rd
Chester, VA 23831-1740
Phone
(804) 748-8677
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401416068 VA Primary

Addresses

Primary practice location

4516 W Hundred Rd
Chester, VA 23831-1740

Mailing address

22090 Lake Jordan LNDG
North Dinwiddie, VA 23803-6587
Phone (804) 586-6176

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
0401416068VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
JDM Dental, PLC Dentist Past Accepting new patients
William F. Callery DDS PLC Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1063906220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22090 LAKE JORDAN LNDG",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238036587",
            "telephone_number": "804-586-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 W HUNDRED RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311740",
            "telephone_number": "804-748-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYNIER",
        "first_name": "MATTHEW",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.