Michelle Renee Mathieson, DMD, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN014503 Issued in GA

Practice address

3005 Royal Blvd S
Suite 200
Alpharetta, GA 30022-1409

Phone

(770) 680-2335

Fax

(770) 710-0317

NPI assigned

May 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Orthogenesis, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Alpharetta, GA
  • NPI 1518355577
  NPD (past)

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

{
    "created_epoch": "1338163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1447510284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10930 CRABAPPLE RD STE 106",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755825",
            "telephone_number": "678-352-1090",
            "fax_number": "678-974-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 ROYAL BLVD S",
            "address_2": "SUITE 200",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221409",
            "telephone_number": "770-680-2335",
            "fax_number": "770-710-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIESON",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-28",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401413477",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN014503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle L. Mason, M.D.
• Meredith Therese Mason, NP
• Nia Massey
• Marlea Mastricola, RD
• Preena Mathew
• Meghan Mathis, OTR/L
• Jyothi N Mattam, M.D
• Cierra Matthews, BCBA
• Curtis Matthews
• Eliza Matthews

• Orthodontics and Dentofacial Orthopedics Dentistry in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.