Vanessa Ivelisse Matos, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS029521L Issued in PA

Practice address

405 Main St
Landisville, PA 17538-1812

Phone

(717) 898-7221

NPI assigned

Dec 27, 2012

Last updated

Mar 25, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1083950703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 PAMPAS DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174046430",
            "telephone_number": "717-764-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MAIN ST",
            "city": "LANDISVILLE",
            "state": "PA",
            "postal_code": "175381812",
            "telephone_number": "717-898-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "VANESSA",
        "middle_name": "IVELISSE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS029521L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Joel Knapp, ED.D.
• Lancaster General Medical Group (Landisville Family Health Center)
• Lancaster Sleep Solutions LLC
• Samantha Elizabeth Lansberry, MPH, RD, LDN
• John Lusaitis Sr., M.S. F.A.A.A.
• Deanna McCaskill
• Shannon Miller, LMSW
• Kristin S Mincarelli, L.P.C.
• William T Moore, R.PH.
• Jared Nagle, LSW

• General Practice Dentistry in Landisville, PA
• Providers in Landisville, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.