Active NPI
Amy Mathew, DMD
- Dentist
- Decatur, GA
National Provider Identifier
1154573798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN014228
- Practice address
- 2883 N Decatur Rd
Suite F
Decatur, GA 30033-7427 - Phone
- (404) 299-7411
- Fax
- (404) 299-5466
- NPI assigned
- Oct 15, 2008
- Sex
- Female
- Sole proprietor
- No
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 | DN014228 | GA | Primary |
Addresses
Primary practice location
2883 N Decatur Rd
Suite F
Decatur, GA 30033-7427
Mailing address
2883 N Decatur Rd
Suite F
Decatur, GA 30033-7427
Phone (404) 299-7411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN014228 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Pacific Coast Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Decatur, GA
- NPI 1376929984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1154573798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2883 N DECATUR RD",
"address_2": "SUITE F",
"city": "DECATUR",
"state": "GA",
"postal_code": "300337427",
"telephone_number": "404-299-7411",
"fax_number": "404-299-5466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2883 N DECATUR RD",
"address_2": "SUITE F",
"city": "DECATUR",
"state": "GA",
"postal_code": "300337427",
"telephone_number": "404-299-7411",
"fax_number": "404-299-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "AMY",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-15",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN014228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.