Individual provider Active NPI

Matthew Perry Byrne, DDS

  • Dentist
  • Eugene, OR
National Provider Identifier
1285082826
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11513 Issued in OR
Practice address
2460 Willamette Street Lane Community College Dental CL
Upper Level
Eugene, OR 97405
Phone
(541) 463-5206
Fax
(405) 515-8170
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6817 OK
Dentist 122300000X D11513 OR Primary

Addresses

Primary practice location

2460 Willamette Street Lane Community College Dental CL
Upper Level
Eugene, OR 97405

Mailing address

LCC Dental Clinic
2460 Willamette Street, Upper Level
Eugene, OR 97405
Phone (541) 463-5206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6817OKMDDentist
D11513ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Rock Dental PLLC Dentist Past Accepting new patients
Enhance Dental of Norman PastSince Jan 17, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1285082826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LCC DENTAL CLINIC",
            "address_2": "2460 WILLAMETTE STREET, UPPER LEVEL",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97405",
            "telephone_number": "541-463-5206",
            "fax_number": "405-515-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 WILLAMETTE STREET LANE COMMUNITY COLLEGE DENTAL CL",
            "address_2": "UPPER LEVEL",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97405",
            "telephone_number": "541-463-5206",
            "fax_number": "405-515-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "MATTHEW",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6817",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.