R Matthew Maddox Dentistry, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12011570A Issued in IN

Legal business name

R MATTHEW MADDOX DENTISTRY, LLC

Doing business as

Maddox Family Dental Center

Practice address

1200 N Walnut St
Hartford City, IN 47348-1338

Phone

(765) 348-4111

NPI assigned

Jul 6, 2016

Last updated

Jul 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond Matthew MaddoxNPI 1205139821

Title

Owner/Dentist

Phone

(765) 348-4111

Specialties & licenses 1

Addresses

Other names 1

• Maddox Family Dental Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raymond Matthew Maddox, DDS

  • General Practice Dentistry
  • Sun Prairie, WI
  • NPI 1205139821
  NPD (past) Authorized official

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1093167884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WALNUT ST",
            "city": "HARTFORD CITY",
            "state": "IN",
            "postal_code": "473481338",
            "telephone_number": "765-348-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WALNUT ST",
            "city": "HARTFORD CITY",
            "state": "IN",
            "postal_code": "473481338",
            "telephone_number": "765-348-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R MATTHEW MADDOX DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "765-348-4111"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011570A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maddox Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Open Door Health Services, Inc. (Open Door Health Services Blackford County)
• Kaitlyn Marie Ort, NP
• Caroline Poland
• Preferred Physicians PC (Preferred Family Physicians)
• Allyson Y Price, PT
• Heather Reasoner
• Reliant Healthcare LLC
• Heather A Scaggs
• Laura A Schible, M.A., LMFTA
• Kevin Wayne Schreiber, M.D.

• Dentist in Hartford City, IN
• Providers in Hartford City, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.