Matthew T Tomoda, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401413453 Issued in VA

Practice address

614 S Main St
Blacksburg, VA 24060-5259

Phone

(540) 292-7662

NPI assigned

Aug 9, 2011

Reactivated

Jun 1, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1114206158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 CANYON RIDGE RD APT 104",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240601277",
            "telephone_number": "540-292-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240605259",
            "telephone_number": "540-292-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMODA",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "deactivation_date": "2023-04-12",
        "reactivation_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Tiller, BCBA, LBA
• James Tillett
• Tilley Chiropractic and Sports Injury Clinic
• Alina H Tobey, DO
• Tomoda Dental PLLC
• Nicholas Torre
• Diego Torres
• David F Tosi, RPH
• Total Skin Care and Laser Center, LLC
• Victor Le Tran

• Dentist in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.