Dexter Witherington Mattox, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN015216 Issued in GA

Practice address

149 Scranton Connector
Brunswick, GA 31525-0514

Phone

(912) 266-8100

Fax

(912) 266-8125

NPI assigned

Jun 7, 2016

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 9, 2021 through Jul 9, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Innova Sleep Institute, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Brunswick, GA
  • NPI 1891652848
  NPD Authorized official
• Coastal Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • St Simons Island, GA
  • NPI 1457735995
  NPD (past)
• Georgia Dental Affiliates, LLC

  dba Coastal Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • St Simons Island, GA
  • NPI 1285411694
  NPD (past)
• Georgia Dental Affiliates, LLC

  dba Coastal Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Marys, GA
  • NPI 1366229775
  NPD (past)
• Jackson P. Morgan, III, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Savannah, GA
  • NPI 1235361908
  NPD (past)
• Southeastern Oral and Maxillofacial Surgical Associates P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Savannah, GA
  • NPI 1801920301
  NPD (past)

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1285083527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 SCRANTON CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250514",
            "telephone_number": "912-266-8100",
            "fax_number": "912-266-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 SCRANTON CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250514",
            "telephone_number": "912-266-8100",
            "fax_number": "912-266-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "DEXTER",
        "middle_name": "WITHERINGTON",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN015216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilberto J Martorell-Marquez, MD
• Alicia M Mason
• Joe C. Massey, DENTIST
• Samantha Marie Massey
• Wendy Mathis
• Huitt Everett Mattox III, M.D.
• Katherine L Maurath, M.D.
• Janice H. Maxwell, R.N.
• Mary Virginia May, NP
• Thomas Geoffrey May

• Oral and Maxillofacial Surgery (Dentist) in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.