Scott Mark Mattheis, D.D.S.
Individual provider Active NPI General Practice Dentistry · Hartford, SD
NPI 1457571705 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457571705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- M-733 (SD)
- Practice address
- 304 W. Hwy 38
Ste. 138
Hartford, SD 57033-0757 - Phone
- (605) 528-6750
- Fax
- (605) 528-6752
- NPI assigned
- Apr 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150130001820 | SD | Order and Referring Only - Oral Surgery |
1850615428 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-733 | SD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mattheis Hartford Dental Clinic, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | M-733 | SD | Yes |
Addresses
Primary practice location
304 W. Hwy 38
Ste. 138
Hartford, SD 57033-0757
Mailing address
304 W. Hwy 38
Ste. 138
Hartford, SD 57033-0757
Phone (605) 528-6750
Other providers in Hartford, SD
- Leisure Living II, Inc
- Donna Marie Lupien
- Lane Ranae Madsen
- Rudi Maske
- Mattheis Hartford Dental Clinic, P.C.
- Rebecca McCoy
- Tyann Nieman
- Casey J Olson
- Mariah Leeann Oyen
- Prairie Rehabilitation Services, Inc
All providers in Hartford, SD · General Practice Dentistry in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.