Matthew R. Fantasia, D.M.D., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 20441 Issued in MA

Legal business name

MATTHEW R. FANTASIA, D.M.D., P.C.

Practice address

372 Washington St
Wellesley, MA 02481-6202

Phone

(781) 235-1146

Fax

(781) 235-9195

NPI assigned

Oct 1, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Matthew R. Fantasia, D.M.D.

Title

President

Phone

(781) 235-1146

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1386995397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816202",
            "telephone_number": "781-235-1146",
            "fax_number": "781-235-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816202",
            "telephone_number": "781-235-1146",
            "fax_number": "781-235-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW R. FANTASIA, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "FANTASIA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-235-1146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN 20441",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "DN 14506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Masters, D.C.
• Anthony Mastrocola
• Abigail Leigh Masucci
• Patricia Mathison, LMHC
• Laura Grace Matlack, PSY.D.
• David William Matthews, DC
• Bradford Richard Mattison, D.M.D.
• Mary Maxwell, NURSE PRACTITIONER
• Denise Mayo, M.D.
• Laura Linda McCann, M.D.

• General Practice Dentistry in Wellesley, MA
• Providers in Wellesley, 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 Oct 15, 2012; 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.