Active NPI
Matthew Meador
- General Practice Dentistry
- San Marcos, CA
National Provider Identifier
1629366240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61821
- Practice address
- 150 Valpreda Rd
San Marcos, CA 92069-2973 - Phone
- (760) 736-6767
- NPI assigned
- Jul 17, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61821 | CA | Primary |
Addresses
Primary practice location
150 Valpreda Rd
San Marcos, CA 92069-2973
Mailing address
4422 Del Mar Ave
San Diego, CA 92107-3619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150324001556 | CA | Order and Referring Only - Oral Surgery | 8527385939 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61821 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1629366240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4422 DEL MAR AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921073619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 VALPREDA RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920692973",
"telephone_number": "760-736-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEADOR",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-17",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "61821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.