Matthew Bluth

Primary specialty

DentistTaxonomy code 122300000X

License

1001782-15 Issued in WI

Practice address

202 E Birch St
Abbotsford, WI 54405-9439

Phone

(715) 223-4844

NPI assigned

Apr 6, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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 and National Provider Directory roles.

• Bluth Dentistry LLC

  • Dentist
  • Abbotsford, WI
  • NPI 1386300689
  NPD Authorized official
• First City Dental of Abbotsford, SC

  • Dentist
  • Abbotsford, WI
  • NPI 1053432955
  NPD (past)

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1518490408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 W NORTH ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491820",
            "telephone_number": "480-721-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E BIRCH ST",
            "city": "ABBOTSFORD",
            "state": "WI",
            "postal_code": "544059439",
            "telephone_number": "715-223-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUTH",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001782-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@firstcitydental.net",
            "affiliation": "N",
            "address_1": "202 E Birch St",
            "city": "Abbotsford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544059439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alpine Medical Equipment LLC
• Astia Health Clinical Services, SC
• Jamie Lynn Barker, MSN, FNP-C
• Bedrock HCS at Abbotsford LLC
• Bluth Dentistry LLC
• Christine A Brewer, PTA
• Central Fire & EMS District
• Melissa Sue Daniels, PT
• Judith Anne Davis, CADC-D
• Dycora Transitional Health - Abbotsford LLC

• Dentist in Abbotsford, WI
• Providers in Abbotsford, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.