Individual provider Active NPI

Matthew Thunberg, D.D.S.

  • General Practice Dentistry
  • Torrance, CA
National Provider Identifier
1245348515
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50002 Issued in CA
Practice address
3610 Lomita Blvd
Suite 102
Torrance, CA 90505-3919
Phone
(323) 376-6487
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50002 CA Primary

Addresses

Primary practice location

3610 Lomita Blvd
Suite 102
Torrance, CA 90505-3919

Mailing address

3610 Lomita Blvd
Suite 102
Torrance, CA 90505-3919
Phone (323) 376-6487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150306000212 CA Order and Referring Only - Other (Non-Physician) 6507182706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1245348515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 LOMITA BLVD",
            "address_2": "SUITE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053919",
            "telephone_number": "323-376-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 LOMITA BLVD",
            "address_2": "SUITE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053919",
            "telephone_number": "323-376-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUNBERG",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.