Individual provider Active NPI

Matthew Kasiar, DMD

  • Dentist
  • Franklin, TN
National Provider Identifier
1396877429
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10290 Issued in TN
Practice address
3991 Carothers Parkway
Franklin, TN 37067
Phone
(618) 841-0971
NPI assigned
Mar 12, 2007
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019027149 IL
Dentist 122300000X 10290 TN Primary

Addresses

Primary practice location

3991 Carothers Parkway
Franklin, TN 37067

Mailing address

1738 Fontanella Dr
Brentwood, TN 37027-2502
Phone (618) 841-0971

Other practice location 1

1315 Bell Rd
Antioch, TN 37013-3730
Phone (217) 540-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10290TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Practice, PLLC CurrentSince Mar 4, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1396877429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 FONTANELLA DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272502",
            "telephone_number": "618-841-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 CAROTHERS PARKWAY",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "37067",
            "telephone_number": "618-841-0971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 Bell Rd",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370133730",
            "country_code": "US",
            "telephone_number": "217-540-5800",
            "fax_number": "615-717-0515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASIAR",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2021-02-23",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027149",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.