Individual provider Active NPI

Matthew H Pizza, DMD

  • General Practice Dentistry
  • Camarillo, CA
National Provider Identifier
1649302308
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45957 Issued in CA
Practice address
450 Rosewood Ave
Suite 105
Camarillo, CA 93010-5914
Phone
(805) 484-1022
Fax
(805) 484-1322
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 45957 CA Primary

Addresses

Primary practice location

450 Rosewood Ave
Suite 105
Camarillo, CA 93010-5914

Mailing address

450 Rosewood Ave
Suite 105
Camarillo, CA 93010-5914
Phone (805) 484-1022

Other identifiers 1

IdentifierTypeStateIssuer
850412 & 781138OtherCAUNITED CONCORDIA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329001673 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577860097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45957CAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Sprague, Packham & Pizza Dental Corporation General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649302308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 ROSEWOOD AVE",
            "address_2": "SUITE 105",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105914",
            "telephone_number": "805-484-1022",
            "fax_number": "805-484-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ROSEWOOD AVE",
            "address_2": "SUITE 105",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105914",
            "telephone_number": "805-484-1022",
            "fax_number": "805-484-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIZZA",
        "first_name": "MATTHEW",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "850412 & 781138",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.