Active NPI
Stephen R Matheson, DDS PS
- Dental Assistant
- Kennewick, WA
National Provider Identifier
1538238779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- DE00010578
- Practice address
- 5000 W Clearwater Ave
Kennewick, WA 99336 - Phone
- (509) 783-5000
- Fax
- (509) 783-8349
- NPI assigned
- Nov 6, 2006
- Last updated
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00004645 | WA | |
| Dental Assistant | 126800000X | DE00008483 | WA | |
| Dental Assistant | 126800000X | DE00010578 | WA | Primary |
Addresses
Primary practice location
5000 W Clearwater Ave
Kennewick, WA 99336
Mailing address
5000 W Clearwater Ave
Kennewick, WA 99336
Phone (509) 783-5000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5510003 | Medicaid | WA | |
| 4645 | Other | WDS | |
| 408285 | Other | UNITED CONCORDIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00004645 | WA | MD | Dentist |
| DE00008483 | WA | MD | General Practice Dentistry |
| DE00010578 | WA | MD | Dental Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Han, Rose and Rhoten, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1538238779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 W CLEARWATER AVE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99336",
"telephone_number": "509-783-5000",
"fax_number": "509-783-8349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 W CLEARWATER AVE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99336",
"telephone_number": "509-783-5000",
"fax_number": "509-783-8349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHESON",
"first_name": "STEPHEN",
"middle_name": "R",
"credential": "DDS PS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00004645",
"primary": false
},
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "WA",
"license": "DE00008483",
"primary": false
},
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "WA",
"license": "DE00010578",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5510003",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WDS",
"identifier": "4645",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "408285",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.