Active NPI
Reji Mathew, DDS
- General Practice Dentistry
- Allen, TX
National Provider Identifier
1376742353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23355
- Practice address
- 1511 W McDermott Dr Ste 200
Allen, TX 75013-3096 - Phone
- (469) 675-3890
- NPI assigned
- Jul 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23355 | TX | Primary |
Addresses
Primary practice location
1511 W McDermott Dr Ste 200
Allen, TX 75013-3096
Mailing address
1511 W McDermott Dr Ste 200
Allen, TX 75013-3096
Phone (469) 675-3890
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23355 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1376742353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 W MCDERMOTT DR STE 200",
"city": "ALLEN",
"state": "TX",
"postal_code": "750133096",
"telephone_number": "469-675-3890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 W MCDERMOTT DR STE 200",
"city": "ALLEN",
"state": "TX",
"postal_code": "750133096",
"telephone_number": "469-675-3890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "REJI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-11",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "23355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.