Mathew C Petersen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3330 Issued in NM

Practice address

2001 E Lohman Ave
Ste 121
Las Cruces, NM 88001-3167

Phone

(575) 527-4746

NPI assigned

Jul 9, 2010

Last updated

Sep 2, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NM

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

Practice roles

Locations

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.

• Las Cruces Dental Solutions LLC

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1346952942
  NPD Authorized official
• LC Sleep Solutions LLC

  • Customized Equipment (DME)
  • Las Cruces, NM
  • NPI 1669012241
  NPD Authorized official
• Mathew Petersen DDS PC

  dba Las Cruces Dental Solutions

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1457886913
  Authorized official Same address or phone

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1215249917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E LOHMAN AVE",
            "address_2": "STE 121",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013167",
            "telephone_number": "575-527-4746",
            "fax_number": "575-524-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E LOHMAN AVE",
            "address_2": "STE 121",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013167",
            "telephone_number": "575-527-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MATHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Wayne Perry
• Michael Perry, PHARM. D.
• Personal Touch Home Care LLC
• Perview Inc
• Mary P Peschka, OTR
• Alexandra Sage Peterson
• Christine Maria Peterson, RD
• Crysta Peterson, PHARMD
• Debra Lynn Peterson, LMHC
• Joann Peterson

• General Practice Dentistry in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.