Active NPI
Nicholas J Matthews, D.D.S.
- Dentist
- Redondo Beach, CA
National Provider Identifier
1457512378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54798
- Practice address
- 2700 Marine Ave Ste 105
Redondo Beach, CA 90278-1124 - Phone
- (310) 675-7768
- NPI assigned
- Jun 23, 2008
- 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 | 54798 | CA | Primary |
Addresses
Primary practice location
2700 Marine Ave Ste 105
Redondo Beach, CA 90278-1124
Mailing address
2700 Marine Ave Ste 105
Redondo Beach, CA 90278-1124
Phone (310) 675-7768
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54798 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1457512378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 MARINE AVE STE 105",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902781124",
"telephone_number": "310-675-7768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 MARINE AVE STE 105",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902781124",
"telephone_number": "310-675-7768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "NICHOLAS",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-23",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.