Matthew Stephen Prescott, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-022895 Issued in IL

Practice address

1640 N. Wells Street
Suite 205
Chicago, IL 60614

Phone

(312) 642-4218

Fax

(312) 642-6418

NPI assigned

Dec 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Gina L. Tambornini DDS Inc

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1861648818
  NPD (past)

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1649416710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 N. WELLS STREET",
            "address_2": "SUITE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "312-642-4218",
            "fax_number": "312-642-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 N. WELLS STREET",
            "address_2": "SUITE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "312-642-4218",
            "fax_number": "312-642-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-19",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-022895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prep Performance Center, LLC
• Prescience Diagnostics LLC
• Janice Prescod, DO
• Prescott Counseling
• Casey Prescott, M.S. CCC-SLP
• Presence Ambulatory Services (Resurrection Open MRI & Imaging Center)
• Presence Behavioral Health
• Presence Behavioral Health
• Presence Chicago Hospitals Network (Presence Nazareth Family Health Center)
• Presence Chicago Hospitals Network (Presence Saint Mary of Nazareth Hospital)

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.