Kolver Matos, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002358-15 Issued in WI

Practice address

N112W16286 Mequon Rd
Germantown, WI 53022-3306

Phone

(262) 725-4085

NPI assigned

Apr 28, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Allenton Family Dentistry

  • Dental Clinic/Center
  • Allenton, WI
  • NPI 1831760784
  NPD Authorized official
• Quirt Family Dentistry, S.C.

  • General Practice Dentistry
  • Germantown, WI
  • NPI 1427675362
  NPD

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1568083772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3757 E GRANGE AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531102363",
            "telephone_number": "815-762-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W16286 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223306",
            "telephone_number": "262-725-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "KOLVER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002358-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodie A Martens, MSW, LCSW
• Jessica Rae Martinez
• Douglas Marx, D.O.
• Michael D Mason, CRNA
• Cara Elise Mastin, LPC
• Adrienne M. Maurer, MD
• Kara Mayerbock, APNP, FNP
• Dane W McCullough, DC
• Kira L McDonald, PT
• Lisa A McInnes, LPC, OT

• General Practice Dentistry in Germantown, WI
• Providers in Germantown, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.