MD Endodontics, LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

MD ENDODONTICS, LLC

Practice address

1804 Frederica Rd Ste B
Saint Simons Island, GA 31522-2044

Phone

(912) 268-2800

NPI assigned

Aug 2, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Diandreth, DMDNPI 1396882734

Title

President

Phone

(912) 268-2800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Matthew David Diandreth, D.M.D.

  • Endodontics
  • Pittsburgh, PA
  • NPI 1396882734
  NPD Authorized official

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1215619069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 FREDERICA RD STE B",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222044",
            "telephone_number": "912-268-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 FREDERICA RD STE B",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222044",
            "telephone_number": "912-268-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 N Gross Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Kingsland",
            "state": "GA",
            "postal_code": "315486263",
            "country_code": "US",
            "telephone_number": "912-955-4580",
            "fax_number": "912-955-4584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MD ENDODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "DIANDRETH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-268-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Lynn Mason, MS,PT
• Gidget Bragg Maybin
• Lachrista McCarter
• Tammyette McKoy
• Jennifer McPeters, PMHNP
• Medical Aesthetic Center LLC
• Suzanne R. Mericle, D.M.D.
• Michael Timothy Miller, MPT
• Robert Dancy Millican, OD
• Victoria Monti, OT

• Endodontics in Saint Simons Island, GA
• Providers in Saint Simons Island, GA by specialty
• Endodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.