Matthew H Willis DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9322 Issued in NC

Legal business name

MATTHEW H WILLIS DDS PLLC

Practice address

2709 Salisbury PLN
Raleigh, NC 27613-4333

Phone

(919) 610-7915

NPI assigned

Aug 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Willis, DDS

Title

Owner

Phone

(919) 610-7915

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1578939559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 SALISBURY PLN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276134333",
            "telephone_number": "919-610-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 SALISBURY PLN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276134333",
            "telephone_number": "919-610-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW H WILLIS DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-610-7915",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Raleigh, NC
• Providers in Raleigh, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.