Individual provider Active NPI

Matthew Thomas Streelman, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mercer Island, WA
National Provider Identifier
1093055097
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
MD61048195 Issued in WA
Practice address
3023 80TH Ave SE Ste 200
Mercer Island, WA 98040-6014
Phone
(206) 690-5417
NPI assigned
Feb 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60143704 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X MD61048195 WA Primary

Addresses

Primary practice location

3023 80TH Ave SE Ste 200
Mercer Island, WA 98040-6014

Mailing address

3023 80TH Ave SE Ste 200
Mercer Island, WA 98040-6014
Phone (206) 690-5417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230118001635 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577955905

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DE60143704WAMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: mstreelman72377@direct.llu.edu

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1093055097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 80TH AVE SE STE 200",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980406014",
            "telephone_number": "206-690-5417",
            "fax_number": "206-690-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 80TH AVE SE STE 200",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980406014",
            "telephone_number": "206-690-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREELMAN",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60143704",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "MD61048195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

Verify at the official NPI Registry.