Matt A Mlsna, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

1301 N Alpine Rd
Rockford, IL 61107-2262

Phone

(815) 397-4280

Fax

(815) 484-2436

NPI assigned

Aug 8, 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

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386653111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 KRUPKE RD",
            "city": "CALEDONIA",
            "state": "IL",
            "postal_code": "610119567",
            "telephone_number": "815-765-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N ALPINE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072262",
            "telephone_number": "815-397-4280",
            "fax_number": "815-484-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLSNA",
        "first_name": "MATT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Mitchell, LMFT
• Patricia Anne Mitchell, PMHNP
• Patrick Mitsos
• Francisco J Miyares, M.D.
• MJM Medical Corp
• Allison Mlyniec
• Mobile Physical Therapy
• Mobility Connection, Inc.
• Maria I Modayil, SLP
• Modern Dental of Rockford LLC

• General Practice Dentistry in Rockford, IL
• Providers in Rockford, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.