Charles F Mattingly, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14178 Issued in MO

Practice address

409 Vandiver Dr
BLDG 3 Suite 102
Columbia, MO 65202-3754

Phone

(573) 499-1699

Fax

(573) 442-7897

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467449892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W BRIARWOOD LN",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031607",
            "telephone_number": "573-445-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 VANDIVER DR",
            "address_2": "BLDG 3 SUITE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023754",
            "telephone_number": "573-499-1699",
            "fax_number": "573-442-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "CHARLES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "14178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Matteoni, DO
• Michelle L Matteson-Kome, FNP/GNP
• Matthew Concannon LLC
• Heather L Matthews, P.A.
• Kimberly M Matthews, APRN
• Maryanne M Matzen, RD, LD
• Pamela Arlene Mauch, PHD
• Amanda M Maune, MSW, LMSW
• Kelly Maunu
• Maurizi Isl Home

• General Practice Dentistry in Columbia, MO
• Providers in Columbia, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.