Ryan Paul Matherne, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5120 Issued in LA

Practice address

170 Moores Rd
Suite a
Mandeville, LA 70471-2916

Phone

(985) 727-0991

Fax

(985) 727-0994

NPI assigned

Jan 16, 2008

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 LA

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": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1487830774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 SUGARMILL RD",
            "city": "MATHEWS",
            "state": "LA",
            "postal_code": "703752037",
            "telephone_number": "985-532-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MOORES RD",
            "address_2": "SUITE A",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704712916",
            "telephone_number": "985-727-0991",
            "fax_number": "985-727-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERNE",
        "first_name": "RYAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "LA",
            "license": "5120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Masion Maxwell
• Amanda Theresa Mason, LCSW
• Kaitlin Crane Massey, MD
• Jennifer Matherne, FNP
• Kelly Matherne, LCSW
• Terrence Lenoir Mathers, M.D.
• Leslie Shelton Mathes, LPC
• Paul Mathes, BA - PSYCHOLOGY
• Shauna K. Mathis, D.C.
• Matthew McClanahan Apmllc

• Endodontics in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Endodontics in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.