Active NPI
Matthew David Morris, DMD
- General Practice Dentistry
- Fort Gordon, GA
National Provider Identifier
1598928368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4467
- Practice address
- BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30090-5660 - Phone
- (706) 787-6927
- Fax
- (706) 787-2082
- NPI assigned
- Jul 2, 2008
- Last updated
- Nov 3, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4467 | SC | |
| General Practice Dentistry | 1223G0001X | 4467 | SC | Primary |
Addresses
Primary practice location
BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30090-5660
Mailing address
BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30090-5660
Phone (706) 787-6927
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 9, 2021 through Sep 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Endodontics LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Endodontics
- Summerville, SC
- NPI 1144825993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1598928368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLDG 38717 38TH STREET",
"address_2": "USA DENTAC",
"city": "FT GORDON",
"state": "GA",
"postal_code": "300905660",
"telephone_number": "706-787-6927",
"fax_number": "706-787-2082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 38717 38TH STREET",
"address_2": "USA DENTAC",
"city": "FT GORDON",
"state": "GA",
"postal_code": "300905660",
"telephone_number": "706-787-6927",
"fax_number": "706-787-2082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-02",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "4467",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "4467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.