Matthew Ryan Mynsberge, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

62180 Issued in CA

Practice address

1331 S Eliseo Dr
Greenbrae, CA 94904-2010

Phone

(415) 461-1150

NPI assigned

Jun 30, 2009

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

Enrolled in IN

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Mynsberge, Ruggles & Yang Oral Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenbrae, CA
  • NPI 1205624657
  NPD Authorized official

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1194953992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 S ELISEO DR",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042010",
            "telephone_number": "415-461-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 S ELISEO DR",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042010",
            "telephone_number": "415-461-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYNSBERGE",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "62180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Moschetto, NP
• Nicole Stanton Mott, NP
• Chelsea Murphy, RT(R)(M)
• Victoria Ashley Murray, R.D.
• Tabo Mwikisa-Kelly, RN
• Mynsberge, Ruggles & Yang Oral Surgery, P.C.
• Nadia Naderi, M.D.
• Elizabeth Claire Nadiv, MD
• Nancy a Trahms MD Robert G Trahms MD a Professional Corporation
• Sarena Napier, ASW

• Oral and Maxillofacial Surgery (Dentist) in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.