Matthew Joseph Vierra, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

28748 Issued in TX

Practice address

14500 San Pedro Ave
Suite 102
San Antonio, TX 78232-4391

Phone

(210) 491-0015

Fax

(210) 491-0352

NPI assigned

Oct 4, 2009

Last updated

Nov 22, 2013By the provider in NPPES

Sex

Male

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert R. Lemke DDS, MD, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
  • NPI 1366865081

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1254614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1457686776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10126 SILVERWAGON",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782546034",
            "telephone_number": "210-837-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 SAN PEDRO AVE",
            "address_2": "SUITE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324391",
            "telephone_number": "210-491-0015",
            "fax_number": "210-491-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERRA",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-04",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "28748",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Danielle Vidosh, MD
• Christine Vidouria, DO
• Candice Marie Vieira
• Vielka E Johnson
• Lorena Vielmann, LMSW
• Annie M Viers, LPC, LMFT
• Albert Viesca, PHARMACY STUDENT
• Ricardo Viesca Jr., CPHT
• Amanda Rebecca Vieyra, M.A., SLP
• George Ray Vieyra, M.D.

• Periodontics in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.

Verify at the official NPI Registry.