Matthew Kubovich

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MATTHEW KUBOVICH

Practice address

4949 Westown Pkwy
Suite 150
West Des Moines, IA 50266-6702

Phone

(515) 225-0066

Fax

(515) 226-0998

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Perry Kubovich, D.D.S.NPI 1578532446

Title

Owner

Phone

(515) 225-0066

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Des Moines Pediatric Dental Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Perry Kubovich, D.D.S.

  • Pediatric Dentistry
  • West Des Moines, IA
  • NPI 1578532446
  NPD (past) Authorized official
• Diana Pelzer, DDS

  • Pediatric Dentistry
  • Waukee, IA
  • NPI 1760801062
  NPD (past)

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1386811677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 WESTOWN PKWY",
            "address_2": "STE 150",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502666702",
            "telephone_number": "515-225-0066",
            "fax_number": "515-226-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 WESTOWN PKWY",
            "address_2": "SUITE 150",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502666702",
            "telephone_number": "515-225-0066",
            "fax_number": "515-226-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW KUBOVICH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "KUBOVICH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-225-0066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1291575",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1745344",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35184",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Des Moines Pediatric Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mitchell S Masters, SLP
• Mary Michelle Masterson, A.R.N.P.
• Jenifer Jo Mathers, P.T.A.
• Mely Mary Mathew, M.D
• Gary David Matt, D.D.S.M.S.
• Kathleen Carey Matthews, PH.D.
• Katherine Maurer, MPT
• Maxim Healthcare Services, Inc.
• Timothy P Mayfield, MD
• Rebecca Jo Mayou, OTD

• Pediatric Dentistry in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Pediatric Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.