Andrew William Mattson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30024504 Issued in OH

Practice address

55 Roche Way
Youngstown, OH 44512-6214

Phone

(330) 758-0536

NPI assigned

May 22, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Andrew W Mattson DDS LLC

  • General Practice Dentistry
  • Boardman, OH
  • NPI 1205380888
  NPD (past) Authorized official

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1376922443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 ROCHE WAY",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126214",
            "telephone_number": "330-758-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ROCHE WAY",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126214",
            "telephone_number": "330-758-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-22",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30024504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Matte
• Marian Ann Mattern, CNP, PMHNP, RN
• Krista M Mattessich, LPN
• Gerald A. Matteucci, M.D.
• Julianne Marie Matthews, MD
• Elizabeth A Matuscak, LISW-S
• Andrew Joseph Maughan
• Alyson Maurice
• Max a Malkoff DMD
• Lauren Maxwell

• General Practice Dentistry in Youngstown, OH
• Providers in Youngstown, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.