Active NPI
Matthew David Diandreth, D.M.D.
- Endodontics
- Pittsburgh, PA
National Provider Identifier
1396882734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DS026828L
- Practice address
- 4725 McKnight Rd
Pittsburgh, PA 15237-3414 - Phone
- (412) 366-6990
- Fax
- (412) 366-0218
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DS026828L | PA | Primary |
Addresses
Primary practice location
4725 McKnight Rd
Pittsburgh, PA 15237-3414
Mailing address
11 S Mill St Ste 200
New Castle, PA 16101-3680
Phone (412) 366-6990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160218000723 | PA | Order and Referring Only - Other (Physician) | 3274838925 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS026828L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MD Endodontics, LLC | Endodontics | Current | 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 and National Provider Directory roles.
-
- Endodontics
- St Simons Island, GA
- NPI 1215619069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507852800000",
"number": "1396882734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 S MILL ST STE 200",
"city": "NEW CASTLE",
"state": "PA",
"postal_code": "161013680",
"telephone_number": "412-366-6990",
"fax_number": "412-366-0218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 MCKNIGHT RD",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152373414",
"telephone_number": "412-366-6990",
"fax_number": "412-366-0218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIANDRETH",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2017-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS026828L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.