Individual provider Active NPI

Veronica Catherine Matthews, D.D.S.

  • Dentist
  • Bend, OR
National Provider Identifier
1588043277
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10613 Issued in OR
Practice address
20516 Robal Road
Bend, OR 97701
Phone
(541) 797-6331
NPI assigned
May 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D10613 OR Primary

Addresses

Primary practice location

20516 Robal Road
Bend, OR 97701

Mailing address

20516 Robal Road
Bend, OR 97701
Phone (541) 797-6331

Other practice location 1

2800 E 136th Ave
Thornton, CO 80241-3417
Phone (720) 872-2892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160601000692 CO Order and Referring Only - DentistPractitioner - Dentist 4385934538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10613ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1588043277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20516 ROBAL ROAD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-797-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20516 ROBAL ROAD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-797-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E 136th Ave",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802413417",
            "country_code": "US",
            "telephone_number": "720-872-2892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "VERONICA",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.