Individual provider Active NPI

Matthew Thurston Zieman, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mobile, AL
National Provider Identifier
1588018444
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6318 Issued in AL
Practice address
5901 Grelot Road, Building C
Mobile, AL 36609-3603
Phone
(251) 344-6191
Fax
(254) 344-6794
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6318 AL Primary

Addresses

Primary practice location

5901 Grelot Road, Building C
Mobile, AL 36609-3603

Mailing address

5901 Grelot Road, Building C
Mobile, AL 36609-3603
Phone (251) 344-6191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170309002067 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668756750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6318ALMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1588018444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 GRELOT ROAD, BUILDING C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366093603",
            "telephone_number": "251-344-6191",
            "fax_number": "254-344-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 GRELOT ROAD, BUILDING C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366093603",
            "telephone_number": "251-344-6191",
            "fax_number": "254-344-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEMAN",
        "first_name": "MATTHEW",
        "middle_name": "THURSTON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "6318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.