Active NPI
Matthew Chemath Nolen, D.D.S.
- Dentist
- Sacramento, CA
National Provider Identifier
1619429644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 101358
- Practice address
- 4412 Cool CT
Sacramento, CA 95821-2912 - Phone
- (213) 220-9605
- NPI assigned
- Oct 25, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | D009595 | AZ | |
| Dentist | 122300000X | 101358 | CA | Primary |
Addresses
Primary practice location
4412 Cool CT
Sacramento, CA 95821-2912
Mailing address
4412 Cool CT
Sacramento, CA 95821-2912
Phone (213) 220-9605
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
| License | State | Type | Specialty |
|---|---|---|---|
| D009595 | AZ | MD | Dentist |
| 101358 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1619429644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4412 COOL CT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958212912",
"telephone_number": "213-220-9605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4412 COOL CT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958212912",
"telephone_number": "213-220-9605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLEN",
"first_name": "MATTHEW",
"middle_name": "CHEMATH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-25",
"last_updated": "2024-05-14",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D009595",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "101358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.