Matthew J McCullough, DMD, 3 LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MATTHEW J MCCULLOUGH, DMD, 3 LLC

Doing business as

Great River Dental-East Alton

Practice address

96 S 9TH St
East Alton, IL 62024-1715

Phone

(618) 259-1400

NPI assigned

Jun 30, 2025

Organization subpart

No

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

Authorized official

Name

Matthew McCullough, DMDNPI 1497894307

Title

President

Phone

(618) 339-7248

Specialties & licenses 1

Addresses

Other names 1

• Great River Dental-East Alton Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew James McCullough, D.M.D.

  • Dentist
  • Greenville, IL
  • NPI 1497894307
  NPD Authorized official
• Kyle Blake Hagen, D.M.D

  • General Practice Dentistry
  • East Alton, IL
  • NPI 1528139227
  NPD (past)

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1295624948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 S 9TH ST",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 S 9TH ST",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241715",
            "telephone_number": "618-259-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW J MCCULLOUGH, DMD, 3 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-29",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-339-7248",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great River Dental-East Alton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana Sue Livingston, RPH
• M-Lab Enterprises,LTD.
• Mangi Chiropractic & Acupuncture, Inc.
• Andrea M. Mangi
• Michael Todd Massie, D.M.D.
• Sonia Marie Matthews, MD
• Metro East Periodontics, PLLC (Metro East Dental Implants & Periodontics)
• Shelby Murphy
• Nurses Station, P.C.
• Emily Louise Ogle

• Dental Clinic/Center in East Alton, IL
• Providers in East Alton, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.