Matthew Bruce Fournier, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20495 Issued in FL

Practice address

77 South Shore Drive
Miramar Beach, FL 32550-5822

Phone

(850) 262-9488

NPI assigned

Jul 9, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1588005490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SOUTH SHORE DRIVE",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325505822",
            "telephone_number": "850-262-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SOUTH SHORE DRIVE",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325505822",
            "telephone_number": "850-262-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURNIER",
        "first_name": "MATTHEW",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20495",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Fielder
• FL Hud Destin, LLC
• Foodstuff
• Amber Fordham
• Forefront Dermatology, S.C.
• Alaina Fox, BCBA
• Alecia Marsha-Kaye Francis Rosa, RBT
• Tobias Fredeking
• Autumn Sierra Frutos-Creamer, RBT
• Galen Inpatient Physicians PC

• General Practice Dentistry in Miramar Beach, FL
• Providers in Miramar Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.