Matthew Lawrence Rasche, D.D.S. M.S.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12011284A Issued in IN

Practice address

828 S Auto Mall Rd
Bloomington, IN 47401-5430

Phone

(812) 333-5437

Fax

(812) 333-6305

NPI assigned

May 20, 2009

Last updated

Jul 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Indiana Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Bloomington, IN
  • NPI 1356634471
  NPD (past) Authorized official
• J Keith Roberts DDS LLC

  • Pediatric Dentistry
  • Bloomington, IN
  • NPI 1518290550
  NPD (past)

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1619102647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 S AUTO MALL RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015430",
            "telephone_number": "812-333-5437",
            "fax_number": "812-333-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 S AUTO MALL RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015430",
            "telephone_number": "812-333-5437",
            "fax_number": "812-333-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASCHE",
        "first_name": "MATTHEW",
        "middle_name": "LAWRENCE",
        "credential": "D.D.S.  M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-20",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011284A",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12011284A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201019080A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise L Rambo, MS LMHC
• Samuel Randazzo
• Leila Randle
• Lynda S Ransburg, MSW, LCSW
• Therese Ransel, M.S.W.
• Travis Rathbun
• Amy Ruth Ratliff Kessens, M.D.
• Wesley W Ratliff, MD
• Larry Dean Ratts, MD
• Susan J Rautio-Dietz, PH.D.

• Pediatric Dentistry in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.