Matthew Ralph Baumgarth, D.D.S., M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D7910 Issued in OR

Practice address

10365 SE Sunnyside Rd Ste 260
Clackamas, OR 97015-5707

Phone

(503) 698-4484

Fax

(503) 698-5033

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Mt. Scott Endodontics, PC

  • Dental Clinic/Center
  • Clackamas, OR
  • NPI 1306951074
  NPD (past) Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588674964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD STE 260",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155707",
            "telephone_number": "503-698-4484",
            "fax_number": "503-698-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD STE 260",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155707",
            "telephone_number": "503-698-4484",
            "fax_number": "503-698-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTH",
        "first_name": "MATTHEW",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D7910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID #",
            "identifier": "11402877",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane Jackson Bass
• Lyudmila Batazhan, RDH
• Wendy Anne Batchelor Smith, R.N.
• Gregory William Battles, PHARMD, RPH
• Catherine Lydia Bauman-Virnig, M.S.
• Danielle Naomi Baxter, MA, LMFT, QMHP
• Natalie E Baxter, PA-C
• Aaron Patrick Bayne, M.D.
• Bronwyn Baz, MD
• BD-Clackamas, LLC (Brookside Dental-Clackamas)

• Endodontics in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Endodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.