Individual provider Active NPI

Matthew Robert Torres, MD, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
National Provider Identifier
1073928859
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
39834 Issued in TX
Practice address
4499 Medical Dr Ste 190
San Antonio, TX 78229-3768
Phone
(210) 614-3915
NPI assigned
Jun 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 39834 TX Primary

Addresses

Primary practice location

4499 Medical Dr Ste 190
San Antonio, TX 78229-3768

Mailing address

4499 Medical Dr Ste 190
San Antonio, TX 78229-3768
Phone (210) 614-3915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 3, 2023 through Oct 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39834TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
United Oral Surgery - El Paso, PLLC Oral and Maxillofacial Surgery CurrentSince Dec 22, 2024 Accepting new patients
Alamo Maxillofacial Surgical Associates, PA Oral and Maxillofacial Surgery CurrentSince Apr 15, 2022 Accepting new patients

Locations

134 Menger Spgs
Ste 1200
Boerne, TX 78006
Phone (830) 815-2480

7878 Gateway Blvd E
Ste 301
El Paso, TX 79915
Phone (361) 992-3873

4499 Medical Dr
Ste 190
San Antonio, TX 78229
Phone (210) 614-3915

4499 Medical Dr
#3190
San Antonio, TX 78229

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1073928859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 190",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293768",
            "telephone_number": "210-614-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 190",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293768",
            "telephone_number": "210-614-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "credential": "MD, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "39834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.