Matthew James Madsen, D.M.D, M.D.
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Escondido, CA
NPI 1164624433 · NPPES record last updated Aug 28, 2013
Key facts
- NPI
- 1164624433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 8480 (KY)
- Practice address
- 839 E Grand Ave
Escondido, CA 92025-3401 - Phone
- (859) 806-3925
- NPI assigned
- May 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 21, 2016 through Nov 21, 2026
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A125274 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
| 8480 | KY | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madsen Andrus Thompson and Soelberg Partnership | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 8480 | KY | Yes |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 62546 | CA | |
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | A125274 | CA |
Addresses
Primary practice location
839 E Grand Ave
Escondido, CA 92025-3401
Mailing address
839 E Grand Ave
Escondido, CA 92025-3401
Phone (859) 806-3925
Other providers in Escondido, CA
- Madi Med LLC
- Gary Addison Madison
- Eloise Madriaga
- Saralena Isabel Madrid
- Madsen Andrus Thompson and Soelberg Partnership
- Jayanthi Magesh
- Michael Thomas Magnuson
- Martha Patricia Magos-Brewer
- Daniel Magos
- Celena Martina Mahan
All providers in Escondido, CA · Oral and Maxillofacial Surgery (Dentist) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.