Robert Matiasevich Jr DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

21480 Issued in CA

Legal business name

ROBERT MATIASEVICH JR DDS INC

Practice address

1775 Dominican Way
Santa Cruz, CA 95065

Phone

(831) 476-7272

Fax

(831) 476-1446

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Robert N Matiasevich, DDS

Title

Dentist

Phone

(831) 476-7272

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Robert N Matiasevich Jr., DDS

  • Dentist
  • Santa Cruz, CA
  • NPI 1598805996
  Medicare reassignment NPD
• Angela Chai, DMD

  • General Practice Dentistry
  • Santa Cruz, CA
  • NPI 1114309473
  NPD (past)
• Robert N Matiasevich Sr., DDS

  • Dentist
  • Santa Cruz, CA
  • NPI 1417160904
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1235278441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-476-7272",
            "fax_number": "831-476-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-476-7272",
            "fax_number": "831-476-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT MATIASEVICH JR DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "MATIASEVICH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "831-476-7272",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "21480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Elizabeth Rizzi, ACSW
• Candace J Robb, L.AC.
• Glenn Brian Robbins, R.PH.
• Devon Roberson, LVN
• Robert C. Jones M.D.Medical Corporation
• Natalia Roberti
• Alex Roberts
• Elli Nichole Roberts
• Judith Roberts
• Katheryn Roberts

• Dentist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.