Thomas Michael Mattern, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3892 Issued in AZ

Practice address

4609 E Chandler Blvd
Phoenix, AZ 85048-0424

Phone

(480) 706-4600

NPI assigned

Jul 5, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Desert Dentistry, PLLC

  • General Practice Dentistry
  • Surprise, AZ
  • NPI 1023332418
  NPD (past) Authorized official
• Desert Dentistry, PLLC

  • Dentist
  • Phoenix, AZ
  • NPI 1194843987
  NPD (past) Authorized official
• Kristen M Mayorga PLLC

  • Dental Clinic/Center
  • Phoenix, AZ
  • NPI 1750020186
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1295732337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480424",
            "telephone_number": "480-706-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480424",
            "telephone_number": "480-706-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D3892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER ID",
            "identifier": "094136",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mattalino Orthopaedic Sports Surgical Specialists, LLC
• Shadi Daniel Mattar, DPM
• Kelsey Mattas, DACHM, LAC
• Terrence M Matteo, PH.D.
• Cameron Michele Mattern
• Kaiya Matteson
• Danielle Rodgers Matteucci, LCSW
• Matthew Dorchester, DC, CCSP, LLC
• Matthew J Cavendish, DDS, PLLC
• Matthew Lonier DDS, PLLC

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.

Verify at the official NPI Registry.