Individual provider Active NPI

Matthew Timothy Oshea, DDS

  • General Practice Dentistry
  • Decatur, GA
National Provider Identifier
1316974223
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013128 Issued in GA
Practice address
755 Commerce Dr
Suite 520
Decatur, GA 30030-2627
Phone
(404) 373-7818
Fax
(404) 638-5115
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013128 GA Primary

Addresses

Primary practice location

755 Commerce Dr
Suite 520
Decatur, GA 30030-2627

Mailing address

755 Commerce Dr Ste 600
Decatur, GA 30030-2619
Phone (404) 373-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713002028 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224341730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy J O'Shea DDS PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1316974223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 COMMERCE DR STE 600",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302619",
            "telephone_number": "404-373-7818",
            "fax_number": "404-638-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 COMMERCE DR",
            "address_2": "SUITE 520",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302627",
            "telephone_number": "404-373-7818",
            "fax_number": "404-638-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHEA",
        "first_name": "MATTHEW",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.