Individual provider Active NPI

Matthew L Hubis, DMD

  • Dentist
  • Rock Hill, SC
National Provider Identifier
1164628491
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4342 Issued in SC
Practice address
652 Herrons Ferry Rd Unit 105
Rock Hill, SC 29730-0185
Phone
(803) 590-9525
NPI assigned
Jun 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4342 SC Primary
Dentist 122300000X 9416 NC

Addresses

Primary practice location

652 Herrons Ferry Rd Unit 105
Rock Hill, SC 29730-0185

Mailing address

652 Herrons Ferry Rd Unit 105
Rock Hill, SC 29730-0185
Phone (803) 590-9525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150910000982 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658688528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4342SCMDDentist
9416NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew L. Hubis DMD, PA CurrentSince Feb 8, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1182643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1164628491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 HERRONS FERRY RD UNIT 105",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297300185",
            "telephone_number": "803-590-9525",
            "fax_number": "803-590-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 HERRONS FERRY RD UNIT 105",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297300185",
            "telephone_number": "803-590-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBIS",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-24",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4342",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.