Individual provider Active NPI

Jennifer Cutler Matthews, DDS

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1346391133
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7968 Issued in NC
Practice address
10411 Moncreiffe Rd Ste 107
Raleigh, NC 27617-7820
Phone
(919) 405-7075
Fax
(919) 405-1302
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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 7968 NC Primary

Addresses

Primary practice location

10411 Moncreiffe Rd Ste 107
Raleigh, NC 27617-7820

Mailing address

11217 Presidio Dr
Raleigh, NC 27617-8552
Phone (919) 425-0793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160205000055 NC Order and Referring Only - DentistPractitioner - Dentist 6103120514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7968NCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1346391133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11217 PRESIDIO DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178552",
            "telephone_number": "919-425-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10411 MONCREIFFE RD STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177820",
            "telephone_number": "919-405-7075",
            "fax_number": "919-405-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "JENNIFER",
        "middle_name": "CUTLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.