Joseph L Matise, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DI12743 Issued in NJ

Practice address

135 Jackson Rd
Laurel Professional Center - Suite a
Medford, NJ 08055-9231

Phone

(609) 654-1300

Fax

(609) 654-0040

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• South Jersey Oral & Maxillofacial Surgeons, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Medford, NJ
  • NPI 1447272562
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104859974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 JACKSON RD",
            "address_2": "LAUREL PROFESSIONAL CENTER - SUITE A",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559231",
            "telephone_number": "609-654-1300",
            "fax_number": "609-654-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 JACKSON RD",
            "address_2": "LAUREL PROFESSIONAL CENTER - SUITE A",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559231",
            "telephone_number": "609-654-1300",
            "fax_number": "609-654-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATISE",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI12743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1744607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tesha Monique Marshall
• Sara Marie Martino, LPC
• Thomas James Marzili, M.D.
• Kyle Mason, PHARMD
• Bryanna Mastro, DPT
• Melissa D Matsumura, MS, RD
• William J Matta, EDD
• Rhonda Maute, MPT
• Kristin Maxwell
• Kristin Mazzi

• Oral and Maxillofacial Surgery (Dentist) in Medford, NJ
• Providers in Medford, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.