Matthew Mark Wasemiller, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

60742 Issued in CA

Practice address

2878 Campus Pkwy Ste 1
Riverside, CA 92507-0945

Phone

(951) 571-0011

Fax

(951) 571-0012

NPI assigned

Aug 29, 2011

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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 and National Provider Directory roles.

• Carlisle and Rodgers Dental Corporation

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1093800864
  NPD (past)

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1477834968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 SAN JUAN ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543329",
            "telephone_number": "701-640-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 CAMPUS PKWY STE 1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070945",
            "telephone_number": "951-571-0011",
            "fax_number": "951-571-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASEMILLER",
        "first_name": "MATTHEW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Warren
• Lindsay Warren
• Matthew Blake Warren, MD
• Nicole Elaine Warren
• Tracie Warstler
• Anthony Washington
• Ashley Anita Washington
• Chloe Washington
• Dena Racquel Washington
• Elizabeth Lynne Washington

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.