Organization Active NPI

Michael R Matson DDS, Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Manteca, CA
National Provider Identifier
1154552685
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
23538 Issued in CA
Legal business name
MICHAEL R MATSON DDS, INC
Practice address
1509 W Yosemite Ave Ste B
Manteca, CA 95337-5165
Phone
(209) 832-9346
NPI assigned
Jul 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Authorized official

Name
Mrs. Marilyn Jean Everett
Title
Office Manager
Phone
(209) 823-9346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 23538 CA Primary

Addresses

Primary practice location

1509 W Yosemite Ave Ste B
Manteca, CA 95337-5165

Mailing address

1509 W Yosemite Ave Ste B
Manteca, CA 95337-5165
Phone (209) 832-9346

National Provider Directory

National Provider Directory

Locations

1509 W Yosemite Ave
Ste B
Manteca, CA 95337
Phone (209) 823-9346

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1154552685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 W YOSEMITE AVE STE B",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375165",
            "telephone_number": "209-832-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 W YOSEMITE AVE STE B",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375165",
            "telephone_number": "209-832-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R MATSON DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "209-823-9346",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "23538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.