Elizabeth Dominique Mattsson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23987 Issued in TX

Practice address

1202 E. Sonterra Blvd
Suite 502
San Antonio, TX 78258

Phone

(210) 349-3715

Fax

(210) 545-2008

NPI assigned

Nov 24, 2008

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

Other names 1

• Elizabeth Campos Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

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.

• Elizabeth Mattsson DDS PLLC

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1215388020
  NPD (past) Authorized official
• Shana Nistar, D.D.S. P.C.

  • Preferred Provider Organization
  • San Antonio, TX
  • NPI 1932460318
  NPD (past)

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635033600000",
    "number": "1104071794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E. SONTERRA BLVD",
            "address_2": "SUITE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-349-3715",
            "fax_number": "210-545-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E. SONTERRA BLVD",
            "address_2": "SUITE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-349-3715",
            "fax_number": "210-545-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSSON",
        "first_name": "ELIZABETH",
        "middle_name": "DOMINIQUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2021-10-24",
        "certification_date": "2021-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CAMPOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlyn Matthey
• Erika Matthias, LPC
• Patrick Alan Mattie, DDS, MS
• Brennan Michael Mattingly, IDMT
• Kenisha Mattison Marajah
• Evelyn Matudan, PA-C
• Daniella Sofia Matuk, MD
• Antoni L Matulewicz, MD
• Shiara Lynn Matull, LCDC
• Erin M Maturin, DDS

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2021; 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.