Individual provider Active NPI

Maya Sara Mathai, DDS

  • Pediatric Dentistry
  • Huntersville, NC
National Provider Identifier
1639748387
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
13656 Issued in NC
Practice address
9625 Northcross Center CT Ste 101
Huntersville, NC 28078-7353
Phone
(980) 306-6635
NPI assigned
Jun 17, 2021
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 13656 NC Primary

Addresses

Primary practice location

9625 Northcross Center CT Ste 101
Huntersville, NC 28078-7353

Mailing address

9625 Northcross Center CT Ste 101
Huntersville, NC 28078-7353
Phone (304) 657-7802

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL youthdental2@gmail.com

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

LicenseStateTypeSpecialty
13656NCMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: mmathai2977088@carolinashealthcaresystem.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1639748387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT STE 101",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787353",
            "telephone_number": "304-657-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT STE 101",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787353",
            "telephone_number": "980-306-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "MAYA",
        "middle_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "13656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "youthdental2@gmail.com",
            "affiliation": "N",
            "address_1": "5918 Penn Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152063846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

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

Verify at the official NPI Registry.