Individual provider Active NPI

Matthew Charles Janda, DDS

  • General Practice Dentistry
  • Sterling, CO
National Provider Identifier
1104826759
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4398 Issued in CO
Practice address
801 Iris Dr
Sterling, CO 80751-4740
Phone
(970) 522-4050
Fax
(970) 522-4067
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4398 CO Primary

Addresses

Primary practice location

801 Iris Dr
Sterling, CO 80751-4740

Mailing address

409 Melba Rd
Sterling, CO 80751-8609
Phone (970) 522-1888

Other identifiers 1

IdentifierTypeStateIssuer
02043982MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150522000917 CO Order and Referring Only - DentistPractitioner - Dentist 5799005229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4398COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pradera Dental, P.C. Past Accepting new patients
Matthew C Janda, DDS General Practice PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104826759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 MELBA RD",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807518609",
            "telephone_number": "970-522-1888",
            "fax_number": "970-522-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 IRIS DR",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807514740",
            "telephone_number": "970-522-4050",
            "fax_number": "970-522-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDA",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "4398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02043982",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, CO

Sources for this page

Verify at the official NPI Registry.