NPIMap

Organization Active NPI

Matthew a Hostetler DDS SC

  • General Practice Dentistry
  • Verona, WI
National Provider Identifier
1083128342
Registry record updated Nov 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1769-15 Issued in WI
Legal business name
MATTHEW A HOSTETLER DDS SC
Practice address
161 Horizon Dr Ste 103C
Verona, WI 53593-1250
Phone
(260) 845-7350
NPI assigned
Nov 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2017

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

Authorized official

Name
Dr. Matthew Alan Hostetler, DDSNPI 1417180498
Title
Dentist
Phone
(260) 402-5616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1769-15 WI Primary

Addresses

Primary practice location

161 Horizon Dr Ste 103C
Verona, WI 53593-1250

Mailing address

453 Cherry Hill Dr
Madison, WI 53717-2654
Phone (260) 402-5616

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511481600000",
    "number": "1083128342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 CHERRY HILL DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172654",
            "telephone_number": "260-402-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 HORIZON DR STE 103C",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931250",
            "telephone_number": "260-845-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW A HOSTETLER DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-24",
        "last_updated": "2017-11-24",
        "status": "A",
        "authorized_official_last_name": "HOSTETLER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "260-402-5616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1769-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2017; 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.