Individual provider Active NPI

Matthew David Horn, D.D.S.

  • Dentist
  • Union, NJ
National Provider Identifier
1417132945
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9354 Issued in NJ
Practice address
440 Chestnut St
2ND Floor
Union, NJ 07083-3100
Phone
(908) 686-0409
Fax
(908) 686-7967
NPI assigned
Jan 3, 2008
Last updated
Jan 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9354 NJ Primary

Addresses

Primary practice location

440 Chestnut St
2ND Floor
Union, NJ 07083-3100

Mailing address

440 Chestnut St
2ND Floor
Union, NJ 07083-3100
Phone (908) 686-0409

Other identifiers 1

IdentifierTypeStateIssuer
9354OtherNJSTATE LISCENSE

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521000360 NJ Order and Referring Only - DentistPractitioner - Dentist 0840510582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9354NJMDDentist

Organizations & group practices 2

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": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1417132945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833100",
            "telephone_number": "908-686-0409",
            "fax_number": "908-686-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833100",
            "telephone_number": "908-686-0409",
            "fax_number": "908-686-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "9354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE",
            "identifier": "9354",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.