Individual provider Active NPI

Matthew Obrien, D.M.D.

  • General Practice Dentistry
  • Hollidaysburg, PA
National Provider Identifier
1497122501
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS040571 Issued in PA
Practice address
712 S Logan Blvd
Hollidaysburg, PA 16648-3032
Phone
(814) 946-1950
NPI assigned
Aug 24, 2015
Last updated
Jan 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS040571 PA Primary

Addresses

Primary practice location

712 S Logan Blvd
Hollidaysburg, PA 16648-3032

Mailing address

712 S Logan Blvd
Hollidaysburg, PA 16648-3032
Phone (814) 946-1950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20170508001410 PA Order and Referring Only - DentistPractitioner - Dentist 6507143138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dentasl Care Associates, Inc. Past Accepting new patients
42 North Dental Care LLC PastSince Feb 1, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1497122501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S LOGAN BLVD",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166483032",
            "telephone_number": "814-946-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 S LOGAN BLVD",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166483032",
            "telephone_number": "814-946-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "MATTHEW",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollidaysburg, PA

Sources for this page

Verify at the official NPI Registry.