Individual provider Active NPI

Matthew Allen Sanders, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Gold River, CA
National Provider Identifier
1184874893
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
56479 Issued in CA
Practice address
2483 Sunrise Blvd
Gold River, CA 95670-4344
Phone
(916) 635-5717
Fax
(916) 635-1475
NPI assigned
Sep 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 56479 CA Primary

Addresses

Primary practice location

2483 Sunrise Blvd
Gold River, CA 95670-4344

Mailing address

2483 Sunrise Blvd
Gold River, CA 95670-4344
Phone (916) 635-5717

Other identifiers 1

IdentifierTypeStateIssuer
56479OtherCASTATE LICENSE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Sanders DDS, Inc. Orthodontics and Dentofacial Orthopedics CurrentSince Jul 27, 2020 Accepting new patients
Bernard Steinberg DDS Past Accepting new patients

Locations

2483 Sunrise Blvd
Gold River, CA 95670
Phone (678) 373-2536

2865 Sunrise Blvd
Ste 114
Rancho Cordova, CA 95742
Phone (916) 635-5717

Organizations & group practices 2

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1184874893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2483 SUNRISE BLVD",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704344",
            "telephone_number": "916-635-5717",
            "fax_number": "916-635-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 SUNRISE BLVD",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704344",
            "telephone_number": "916-635-5717",
            "fax_number": "916-635-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MATTHEW",
        "middle_name": "ALLEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "56479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "56479",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold River, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.