Matthew Ryan Mayberry, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12783 Issued in NC

Practice address

19824 W Catawba Ave Ste B
Cornelius, NC 28031-4046

Phone

(704) 987-9087

NPI assigned

Jun 17, 2022

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Ryan Mayberry Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gold Hill Dentistry, PLLC

  • Dentist
  • Fort Mill, SC
  • NPI 1114287042

  General Practice

  NPD (past)

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1174254544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SOUTH BLVD APT 405",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036520",
            "telephone_number": "828-301-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19824 W CATAWBA AVE STE B",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314046",
            "telephone_number": "704-987-9087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1716 Kenilworth Ave Ste 180",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282036086",
            "country_code": "US",
            "telephone_number": "704-802-5626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2848 Pleasant Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297089499",
            "country_code": "US",
            "telephone_number": "803-547-4466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-17",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "10291",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "MAYBERRY",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mary Ann Stanley
• Lindsey Burns Mashburn, M.D.
• Heather K Mataraza
• Matts Mediride
• Kendall Paige Maurer, MA, NCC, LCMHCA
• Jeshrine Mazhil
• Mary-Clara Pearl McAlister
• Rebecca C McCall, DNM
• Jamie Marie McChesney, RBT
• Elise Dawn McCutcheon, LMBT

• General Practice Dentistry in Cornelius, NC
• Providers in Cornelius, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.