Devin T Matsumori, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7987460-9921 Issued in UT

Practice address

870 E 9400 S
Sandy, UT 84094-3666

Phone

(801) 571-8391

NPI assigned

Mar 30, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Networks

• UT PPO D-SNP

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.

• Matsumori Dental, PLLC

  • Dental Clinic/Center
  • Sandy, UT
  • NPI 1114324456
  NPD (past) Authorized official
• Dr. David E. Jackson DDS PC

  • General Practice Dentistry
  • Sandy, UT
  • NPI 1881908622
  NPD (past)

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1225327281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 E 9400 S STE 110",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943689",
            "telephone_number": "801-571-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 E 9400 S",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943666",
            "telephone_number": "801-571-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMORI",
        "first_name": "DEVIN",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008150",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7987460-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rima Mat
• Makerita Matapula
• Douglas Eric Mathews
• Julie Mathewson, LCSW
• Matsumori Dental, PLLC
• Suzanne Michelle Matthes, APRN
• Sierra Matthews
• Arthur Matua
• Maxim Healthcare Services, Inc.
• Maxim Healthcare Services, Inc.

• Dentist in Sandy, UT
• Providers in Sandy, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.