Active NPI
Matthew J Aitken, D.D.S.
- Dentist
- South Sioux City, NE
National Provider Identifier
1447639232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6280
- Practice address
- 1509 W 29TH St
South Sioux City, NE 68776-9668 - Phone
- (402) 494-5445
- Fax
- (402) 494-7630
- NPI assigned
- May 26, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6280 | NE | Primary |
Addresses
Primary practice location
1509 W 29TH St
South Sioux City, NE 68776-9668
Mailing address
1509 W 29TH St
P O Box 986
South Sioux City, NE 68776-9668
Phone (402) 494-5445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- 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 |
|---|---|---|---|---|
| I20160225000684 | NE | Order and Referring Only - Dentist | 2365747508 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1447639232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 W 29TH ST",
"address_2": "P O BOX 986",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687769668",
"telephone_number": "402-494-5445",
"fax_number": "402-494-7630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 W 29TH ST",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687769668",
"telephone_number": "402-494-5445",
"fax_number": "402-494-7630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AITKEN",
"first_name": "MATTHEW",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-26",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "6280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.