Individual provider Active NPI

John Michael Matthews, DDS

  • Dentist
  • Hot Springs Village, AR
National Provider Identifier
1073734000
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2660 Issued in AR
Practice address
110 Estel Way
Suite a
Hot Springs Village, AR 71909
Phone
(501) 922-1045
Fax
(501) 922-6217
NPI assigned
May 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2660 AR Primary

Addresses

Primary practice location

110 Estel Way
Suite a
Hot Springs Village, AR 71909

Mailing address

110 Estel Way
Suite a
Hot Springs Village, AR 71909
Phone (501) 922-1045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20170710002745 AR Order and Referring Only - DentistPractitioner - Dentist 7719256551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2660ARMDDentist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073734000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ESTEL WAY",
            "address_2": "SUITE A",
            "city": "HOT SPRINGS VILLAGE",
            "state": "AR",
            "postal_code": "71909",
            "telephone_number": "501-922-1045",
            "fax_number": "501-922-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ESTEL WAY",
            "address_2": "SUITE A",
            "city": "HOT SPRINGS VILLAGE",
            "state": "AR",
            "postal_code": "71909",
            "telephone_number": "501-922-1045",
            "fax_number": "501-922-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "2660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs Village, AR

Sources for this page

Verify at the official NPI Registry.