Mateusz Kolodziejczyk, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DB-2026-0109 Issued in NM

Practice address

12080 LB Lindbeck Rd
Radium Springs, NM 88054

Phone

(575) 526-6200

Fax

(575) 526-2266

NPI assigned

May 7, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mkolodziejczyk480913@wellspan.direct-ci.com

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.

• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Deming, NM
  • NPI 1194443135
  NPD (past)
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Radium Springs, NM
  • NPI 1770734865
  NPD (past)
• Keystone Rural Health Center

  • Community/Retail Pharmacy
  • Chambersburg, PA
  • NPI 1053105288
  NPD (past)
• Keystone Rural Health Center

  • Federally Qualified Health Center (FQHC)
  • Chambersburg, PA
  • NPI 1780478933
  NPD (past)

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1194515817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12080 LB LINDBECK RD",
            "city": "RADIUM SPRINGS",
            "state": "NM",
            "postal_code": "88054",
            "telephone_number": "575-526-6200",
            "fax_number": "575-526-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODZIEJCZYK",
        "first_name": "MATEUSZ",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-07",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DB-2026-0109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Archer Health Center
• Johnny Krynitz
• Colleen Marie Williams, DDS

• Dentist in Radium Springs, NM
• Providers in Radium Springs, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.