Mathew Randle Dennison

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

30161 Issued in TX

Practice address

2806 Flintrock Trce # A206
Austin, TX 78738-1745

Phone

(512) 263-3355

NPI assigned

Apr 19, 2014

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

Enrolled in NM

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

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

{
    "created_epoch": "1397865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1477973295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 FLINTROCK TRCE # A206",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787381745",
            "telephone_number": "512-263-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 FLINTROCK TRCE # A206",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787381745",
            "telephone_number": "512-263-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "MATHEW",
        "middle_name": "RANDLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-19",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "30161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Kay Denning, OTA
• Emma Denning
• J. Adrian Dennington, DO
• Dennis E Smith OD PA
• Lisa J Dennis, MPT
• Ben W Denny, M.D.
• Elizabeth 'Liz' Oliver Denny, MA, LPC ASSOCIATE
• Mariah Denny, APRN
• Bertin Denova, DO
• Lauren Elizabeth Denson, DO

• All providers in Austin, TX
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.