Matthew D Mara, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1857229 Issued in MA

Practice address

490 Lincoln St
Worcester, MA 01605-1936

Phone

(508) 869-4425

NPI assigned

Jun 9, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1376992487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051936",
            "telephone_number": "508-869-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051936",
            "telephone_number": "508-869-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARA",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Manzo
• Nicholas J Manzoli, D.M.D.,M.S.E.
• Marieis Manzueta
• Alena Maple, PSY.D.
• Margaret Maples
• Ketacha Justine Maragh, RN
• Kelsey Marakovits
• Tanaka Mararike
• Tanyaradzwa Mararike, BT
• Oliver Cabailo Marasigan, MD

• General Practice Dentistry in Worcester, MA
• Providers in Worcester, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.