Thiago De Oliveira Matias, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412864 Issued in VA

Practice address

11150 Fairfax Blvd
Suite 301
Fairfax, VA 22030-5066

Phone

(703) 934-4474

NPI assigned

Jul 15, 2010

Last updated

Jul 15, 2010By the provider in NPPES

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 DC

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Matias Dental Group LLC

  • Dentist
  • Washington, DC
  • NPI 1780301465
  NPD Authorized official
• Dr. Jaklin Bezik & Associates

  • Periodontics
  • Fairfax, VA
  • NPI 1780997288
  NPD (past)

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1225341647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 FAIRFAX BLVD",
            "address_2": "SUITE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305066",
            "telephone_number": "703-934-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 FAIRFAX BLVD",
            "address_2": "SUITE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305066",
            "telephone_number": "703-934-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIAS",
        "first_name": "THIAGO",
        "middle_name": "DE OLIVEIRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Previtha Sanna Mathews
• Susan Mathews, RPH
• Frank Mathieu, M.D.
• Joselyn Mathis
• Priya Mathur
• Victoria Matkowski, CCC-SLP
• Matrix Med Inc
• Jennifer M Matro, MD
• Olivia Matson, M.S., CCC-SLP
• James W Mattern, O.D.

• General Practice Dentistry in Fairfax, VA
• Providers in Fairfax, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.