Mehdi B Matin, D.D.S

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DDS60860 Issued in CA

Practice address

9855 Erma Rd Ste 100
San Diego, CA 92131-1007

Phone

(858) 536-2900

Fax

(858) 271-0529

NPI assigned

Jun 30, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmatin43229@scrippshlth.medalliesdirect.net

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942

  Multi-Specialty

  Medicare reassignment NPD
• Harborview Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1053359729

  Multi-Specialty

  Medicare reassignment NPD
• University of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049

  Multi-Specialty

  Medicare reassignment NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891

  Multi-Specialty

  NPD
• Harborview Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1568557312

  Multi-Specialty

  NPD
• University of Washington

  • Community/Retail Pharmacy
  • Seattle, WA
  • NPI 1013950336
  NPD
• University of Washington

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
  • NPI 1205999570
  NPD

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1487965828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11921 CARMEL CREEK RD APT 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302659",
            "telephone_number": "206-486-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 ERMA RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311007",
            "telephone_number": "858-536-2900",
            "fax_number": "858-271-0529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St Hsb Rm B 241",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981957134",
            "country_code": "US",
            "telephone_number": "206-797-3736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATIN",
        "first_name": "MEHDI",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DR 60288665",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WA",
            "license": "DR60288665",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "12011690A",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS60860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Matian, MD
• Anne Emily Matich, MD
• Branko Matich Jr., MD
• Christine Matich, L.C.S.W.
• Nairobi Matila
• Stephanie M Matinpour, PHARM.D.
• Steven Matis, DDS
• Joseph P. Matista, MD
• Catalina Matiz, M.D.
• Petra Matjan

• Oral & Maxillofacial Surgery (D.M.D.) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.