NPIMap

Organization Active NPI

Mate Dental Associates, Inc

  • Dentist
  • Middleburg, FL
National Provider Identifier
1437280385
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN13458 Issued in FL
Legal business name
MATE DENTAL ASSOCIATES, INC
Practice address
4075 CR 218 West
Middleburg, FL 32068
Phone
(604) 282-9371
Fax
(904) 282-0905
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Authorized official

Name
Shannon M. Mate, DMDNPI 1154763910
Title
Owner
Phone
(904) 282-9371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN13458 FL Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN13093 FL
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DH0013458 FL

Addresses

Primary practice location

4075 CR 218 West
Middleburg, FL 32068

Mailing address

4075 CR 218 West
Middleburg, FL 32068
Phone (604) 282-9371

Other names 1

  • Shannon M. Mate, DMD Former legal business name

National Provider Directory

National Provider Directory

Locations

4075 County Road 218
Middleburg, FL 32068
Phone (604) 282-9371

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1437280385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 CR 218 WEST",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "32068",
            "telephone_number": "604-282-9371",
            "fax_number": "904-282-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 CR 218 WEST",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "32068",
            "telephone_number": "604-282-9371",
            "fax_number": "904-282-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATE DENTAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "MATE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-282-9371",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN13458",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN13093",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DH0013458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shannon M. Mate, DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.