Jennifer Mane Matousek-Ronck, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3815 Issued in AR

Practice address

614 E Emma Ave
Suite 300
Springdale, AR 72764-4634

Phone

(479) 751-7417

Fax

(479) 751-4898

NPI assigned

Nov 28, 2006

Last updated

Jan 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1306912373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644634",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644634",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOUSEK-RONCK",
        "first_name": "JENNIFER",
        "middle_name": "MANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5876",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198665608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200086130A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Erin Mason, M.D.
• Kent A Mason, MD
• Ewa M Matczak, MD
• Carol Gene Mathews
• John Shannon Mathis
• Megan Matsuyama, LPC
• Hailey Matthew, MSN, FNP-C
• Brittany Caroline Matthews
• Carrie J Matthews, M.S., CF-SLP
• Kristina Rene Matthews

• Dentist in Springdale, AR
• Providers in Springdale, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.