NPIMap

Organization Active NPI

Michael W. Mathewson, D.D.S., P.C.

  • General Practice Dentistry
  • Dixon, IL
National Provider Identifier
1215000229
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-017139 Issued in IL
Legal business name
MICHAEL W. MATHEWSON, D.D.S., P.C.
Practice address
215 E 2ND St
Dixon, IL 61021-3118
Phone
(815) 284-2749
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Authorized official

Name
Dr. Michael Warne Mathewson, D.D.S.NPI 1710099205
Title
President
Phone
(815) 284-2749

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019-017139 IL Primary

Addresses

Primary practice location

215 E 2ND St
Dixon, IL 61021-3118

Mailing address

215 E 2ND St
Dixon, IL 61021-3118
Phone (815) 284-2749

National Provider Directory

National Provider Directory

Locations

215 E 2nd St
Dixon, IL 61021
Phone (815) 284-1557

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1215000229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 2ND ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213118",
            "telephone_number": "815-284-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 2ND ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213118",
            "telephone_number": "815-284-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W. MATHEWSON, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "MATHEWSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WARNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-284-2749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-017139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.