Matthew D Jervis, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D8638 Issued in OR

Practice address

1030 29TH Ave SW
Albany, OR 97321-3416

Phone

(541) 924-1190

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Oregon Health & Science University

  • Dentist
  • Portland, OR
  • NPI 1396800330
  NPD (past)
• Ross Mitchell DMD

  • Endodontics
  • Albany, OR
  • NPI 1053959585
  NPD (past)
• Ross P. Mitchell D.M.D., LLC

  • Endodontics
  • Albany, OR
  • NPI 1194010660
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1366507337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 29TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213416",
            "telephone_number": "541-924-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 29TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213416",
            "telephone_number": "541-924-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERVIS",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D8638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BSBSO",
            "identifier": "000777005",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel R Jenkins II
• Trevor Jennewine, RPH
• Colby Bleys Christian Jensen-Hansen
• April Jensen, D.O.
• Rachel F Jenson
• Laura Jimenez
• Robin Courtney Johanson, DPT
• Denise Renee Johnson-Koos, D.M.D.
• Allegro Lea Johnson, PH.D.
• Allyssa Johnson, CRM

• Endodontics in Albany, OR
• Providers in Albany, OR by specialty
• Endodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.