Manuel John Matos, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02076600 Issued in NJ

Practice address

230 W Jersey St
Ste 302
Elizabeth, NJ 07202-1352

Phone

(908) 282-6998

Fax

(908) 282-0306

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practitioners 1

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

• Maurice Srour, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
  • NPI 1508243833

  NJ

  Medicare reassignment

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1407859408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W JERSEY ST",
            "address_2": "STE 302",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021352",
            "telephone_number": "908-282-6998",
            "fax_number": "908-282-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W JERSEY ST",
            "address_2": "STE 302",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021352",
            "telephone_number": "908-282-6998",
            "fax_number": "908-282-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "MANUEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02076600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8265607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sholeh Starr Masoudnia, MD
• Evan Mast
• Carolyn Mateo, LPC
• Euclides Mateo, MA, LAC, CPRS
• Jorge A Matos, D.D.S., C.A.G.S.
• Rosalie V Matos, DDS
• Raffee Matossian, MD
• Maria M Mayancela
• Erika Lynn Mayer, PA-C
• James Frances McAnally, MD, FACC, FACP, PA

• Oral and Maxillofacial Surgery (Dentist) in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.

Verify at the official NPI Registry.