Active NPI
Annette F Mata, DDS, MPH
- Dentist
- Rowlett, TX
National Provider Identifier
1285933200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 18836
- Practice address
- 4624 Lakeview Pkwy
Rowlett, TX 75088-4027 - Phone
- (972) 840-2020
- NPI assigned
- Mar 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 18836 | TX | Primary |
Addresses
Primary practice location
4624 Lakeview Pkwy
Rowlett, TX 75088-4027
Mailing address
5270 N O Connor Blvd Apt 1207
Irving, TX 75039-5717
Phone (281) 935-6072
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000 | Other | TX | NONE |
Other names 1
- Annette F Mata-Murphy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150724012059 | TX | Order and Referring Only - Dentist | 5294048849 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Sleep Solutions Corp | Dentist | Current | Accepting new patients |
| La Michoacana Dental Clinic LLC | Past | Accepting new patients | |
| Ddsperio, PLLC | Past | Accepting new patients |
Locations
4624 Lakeview Pkwy
Rowlett, TX 75088
Phone (833) 507-5337
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Houston, TX
- NPI 1225339435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1285933200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5270 N O CONNOR BLVD APT 1207",
"city": "IRVING",
"state": "TX",
"postal_code": "750395717",
"telephone_number": "281-935-6072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4624 LAKEVIEW PKWY",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884027",
"telephone_number": "972-840-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "ANNETTE",
"middle_name": "F",
"credential": "DDS, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-16",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "18836",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "0000000000",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNETTE",
"last_name": "MATA-MURPHY",
"middle_name": "F",
"credential": "DDS, MPH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.