Matt T Phan DMD PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MATT T PHAN DMD PC

Doing business as

M Dental Studio

Practice address

13882 Newport Ave Ste B
Tustin, CA 92780-4666

Phone

(949) 440-1105

Fax

(949) 440-1107

NPI assigned

Nov 24, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Matt Phan, DMDNPI 1881864262

Title

Owner

Phone

(949) 440-1105

Specialties & licenses 1

Addresses

Other names 1

• M Dental Studio Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matt Phan, D.M.D.

  • General Practice Dentistry
  • Tustin, CA
  • NPI 1881864262
  NPD Authorized official

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1366109357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13882 NEWPORT AVE STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804666",
            "telephone_number": "949-440-1105",
            "fax_number": "949-440-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13882 NEWPORT AVE STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804666",
            "telephone_number": "949-440-1105",
            "fax_number": "949-440-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT T PHAN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-440-1105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office@mdentalstudio.com",
            "affiliation": "N",
            "address_1": "13882 Newport Ave Ste B",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927804666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "M Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Masoudaramdds.Inc
• Victoria Mata
• Briana Mateo
• Natalia Shannon Materazzo
• Monika Garg Mathur, M.D.
• Seong-Hye Mau
• Max Mosslehi,D.M.D.,Inc
• Cindy May, M.A.
• Paula S May, PH D
• Celeste Gonzalez Maya

• Dental Clinic/Center in Tustin, CA
• Providers in Tustin, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.