Individual provider Active NPI

Matthew James Heck, D.D.S.

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1588979983
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25819 Issued in TX
Practice address
4410 E Riverside Dr
Austin, TX 78741-4799
Phone
(512) 282-7200
Fax
(512) 282-7204
NPI assigned
Aug 11, 2010
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25819 TX Primary

Addresses

Primary practice location

4410 E Riverside Dr
Austin, TX 78741-4799

Mailing address

4410 E Riverside Dr
Austin, TX 78741-4799
Phone (512) 282-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25819TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1588979983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 E RIVERSIDE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414799",
            "telephone_number": "512-282-7200",
            "fax_number": "512-282-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 E RIVERSIDE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414799",
            "telephone_number": "512-282-7200",
            "fax_number": "512-282-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECK",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.