Matthew Adam Kowaleski, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30-023989 Issued in OH

Practice address

4491 Far Hills Ave
Kettering, OH 45429-2405

Phone

(937) 298-1353

Fax

(937) 298-8344

NPI assigned

Jun 11, 2013

Last updated

Jun 11, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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.

• South Dayton Fammily Dentistry Inc

  • Dentist
  • Dayton, OH
  • NPI 1528362951
  NPD (past)

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1477991586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4491 FAR HILLS AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292405",
            "telephone_number": "937-298-1353",
            "fax_number": "937-298-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 FAR HILLS AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292405",
            "telephone_number": "937-298-1353",
            "fax_number": "937-298-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALESKI",
        "first_name": "MATTHEW",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Komorowski, MD
• Scott David Koncal, MD
• Min Kong, PHARM. D.
• Rachel Marie Korty, NP
• Ronald J. Kossow, MD
• Laura Elizabeth Kramer, MPAP, PA-C
• Teresa R. Kramer
• Jonathan Kreher, M.D.
• Nicole Lynne Kreinbrink, CRNA
• Mindy Kriegbaum, LMT

• Dentist in Kettering, OH
• Providers in Kettering, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.