Xavier Mata, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

8075 Issued in AZ

Practice address

8608 S 30TH Way
Phoenix, AZ 85042-8249

Phone

(480) 268-1569

NPI assigned

Aug 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Karl J. Zeren, D.D.S., LLC

  • Periodontics
  • Timonium, MD
  • NPI 1770816456
  NPD (past)

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1376799445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8608 S 30TH WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850428249",
            "telephone_number": "480-268-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8608 S 30TH WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850428249",
            "telephone_number": "480-268-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "XAVIER",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "60014",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "14245",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "8075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mata Residential Care
• Mata Residential Care
• Gabriel Armani Mata
• George James Mata Jr., COTA/L
• Reyna Mata, MA, BCBA
• Matai LLC
• Miguel Angel Matamoros
• Maria Matas, FNP
• Tim Matatov, M.D.
• Adelina Matatova, PA-C

• Periodontics in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.