Kensuke Matsumoto, D.M.D., M.S., P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

KENSUKE MATSUMOTO, D.M.D., M.S., P.A.

Doing business as

Matsumoto Orthodontics & Periodontics

Practice address

8115 Market St Ste 208
Wilmington, NC 28411-8430

Phone

(910) 726-1000

NPI assigned

Feb 9, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Kensuke Matsumoto, DMDNPI 1134647910

Title

President

Phone

(910) 726-1000

Specialties & licenses 2

Addresses

Other names 1

• Matsumoto Orthodontics & Periodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kensuke Matsumoto, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wilmington, NC
  • NPI 1134647910

  Periodontics

  NPD Authorized official

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645833600000",
    "number": "1124772181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8115 MARKET ST STE 208",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118430",
            "telephone_number": "910-726-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 MARKET ST STE 208",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118430",
            "telephone_number": "910-726-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSUKE MATSUMOTO, D.M.D., M.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-26",
        "certification_date": "2022-02-26",
        "status": "A",
        "authorized_official_last_name": "MATSUMOTO",
        "authorized_official_first_name": "KENSUKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-726-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matsumoto Orthodontics & Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leeann Wilcox Kennedy, LPC
• Lisa Quick Kennedy
• Mary Grace Kennedy
• Samantha Elizabeth Kennedy, MA CF-SLP
• Sonia Vieregge Kennedy, MS, RD, LDN
• Tracy Baucom Kent, LPA
• Misti Annmarie Kepler, DPT
• Christopher Dudley Kern, PA-C
• Kerner Radiology Associates, PA
• Trevor Joseph Dubose Kerns, LMBT

• Orthodontics and Dentofacial Orthopedics Dentistry in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2022; 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.