Matthew Edgar Nelson, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

6736-15 Issued in WI

Practice address

7101 Hoff Street
Building 9240 Love Dental Clinic
Fort Benning, GA 31905

Phone

(269) 326-0065

NPI assigned

Apr 27, 2011

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1285925156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 GREYSTONE SUMMIT DR APT 1008",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097556",
            "telephone_number": "269-326-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 HOFF STREET",
            "address_2": "BUILDING 9240 LOVE DENTAL CLINIC",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "269-326-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6736-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Mae Moyer, MPT
• Yolanda Kay Musgrove, RN
• Dominic Narcisse
• Vicky J. Nehl, RDH
• Amanda Reiko Nelson, DMD
• Nicholas Blaine Nesbitt, M.D.
• Garrett Nevious
• Terry Newton, MD
• Shawn Nguyen, OD
• Brent Austin Nichol, DMD

• Dentist in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.