Active NPI
Matthew Matta, DDS
- Dentist
- Cheney, WA
National Provider Identifier
1568991867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60757878
- Practice address
- 60 Simpson Pkwy
Cheney, WA 99004-2031 - Phone
- (509) 235-2900
- NPI assigned
- Jun 8, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60757878 | WA | |
| Dentist | 122300000X | 60757878 | WA | Primary |
Addresses
Primary practice location
60 Simpson Pkwy
Cheney, WA 99004-2031
Mailing address
60 Simpson Pkwy
Cheney, WA 99004-2031
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60757878 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MC-Chy LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496880000000",
"number": "1568991867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 SIMPSON PKWY",
"city": "CHENEY",
"state": "WA",
"postal_code": "990042031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 SIMPSON PKWY",
"city": "CHENEY",
"state": "WA",
"postal_code": "990042031",
"telephone_number": "509-235-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTA",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-08",
"last_updated": "2017-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60757878",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "60757878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheney, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.