Active NPI
Matthew Abraham Wegrzyn, DDS
- Dentist
- Escondido, CA
National Provider Identifier
1114239837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59432
- Practice address
- 327 S Maple St
Escondido, CA 92025-4122 - Phone
- (858) 598-3384
- NPI assigned
- Jul 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 59432 | CA | Primary |
Addresses
Primary practice location
327 S Maple St
Escondido, CA 92025-4122
Mailing address
6202 Friars Rd Unit 215
San Diego, CA 92108-5012
Phone (858) 598-3384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160622002198 | CA | Order and Referring Only - Other (Non-Physician) | 0345531356 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373155200000",
"number": "1114239837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6202 FRIARS RD UNIT 215",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921085012",
"telephone_number": "858-598-3384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 S MAPLE ST",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920254122",
"telephone_number": "858-598-3384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGRZYN",
"first_name": "MATTHEW",
"middle_name": "ABRAHAM",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-10",
"last_updated": "2013-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2013; 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.