NPIMap

Organization Active NPI

Matt. a. Philson, D.D.S,P.C.

  • Dentist
  • Pueblo, CO
National Provider Identifier
1598174930
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
202236 Issued in CO
Legal business name
MATT. A. PHILSON, D.D.S,P.C.
Practice address
510 Colorado Ave
Pueblo, CO 81004-2013
Phone
(719) 543-1132
Fax
(719) 544-0849
NPI assigned
Aug 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Authorized official

Name
Dr. Matt A Philson, D.D.S.
Title
Owner
Phone
(719) 543-1132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 202236 CO Primary

Addresses

Primary practice location

510 Colorado Ave
Pueblo, CO 81004-2013

Mailing address

510 Colorado Ave
Pueblo, CO 81004-2013
Phone (719) 543-1132

National Provider Directory

National Provider Directory

Locations

510 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-1132

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1598174930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042013",
            "telephone_number": "719-543-1132",
            "fax_number": "719-544-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042013",
            "telephone_number": "719-543-1132",
            "fax_number": "719-544-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT. A. PHILSON, D.D.S,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "PHILSON",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-543-1132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "202236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.