Active NPI
Matthew Gordon Healy, D.D.S.,M.S.
- Endodontics
- Dexter, MI
National Provider Identifier
1356674691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 2901020046
- Practice address
- 2820 Baker Rd
Suite 201B
Dexter, MI 48130-1181 - Phone
- (734) 424-0053
- Fax
- (734) 424-0056
- NPI assigned
- Sep 17, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 2901020046 | MI | Primary |
Addresses
Primary practice location
2820 Baker Rd
Suite 201B
Dexter, MI 48130-1181
Mailing address
2820 Baker Rd
Suite 201B
Dexter, MI 48130-1181
Phone (734) 424-0053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020046 | MI | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Endodontics PC | Endodontics | 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.
-
- Endodontics
- Port Huron, MI
- NPI 1861606212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1356674691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 BAKER RD",
"address_2": "SUITE 201B",
"city": "DEXTER",
"state": "MI",
"postal_code": "481301181",
"telephone_number": "734-424-0053",
"fax_number": "734-424-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 BAKER RD",
"address_2": "SUITE 201B",
"city": "DEXTER",
"state": "MI",
"postal_code": "481301181",
"telephone_number": "734-424-0053",
"fax_number": "734-424-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEALY",
"first_name": "MATTHEW",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"credential": "D.D.S.,M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-17",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MI",
"license": "2901020046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dexter, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.