Active NPI
Jennifer Mary Matlasz, RDH
- Dental Hygienist
- Chicopee, MA
National Provider Identifier
1659758423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 008073
- Practice address
- 340 Dale St
Unit C
Chicopee, MA 01013-4176 - Phone
- (413) 313-1507
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 008073 | CT | Primary |
| Dental Hygienist | 124Q00000X | DH88283 | MA |
Addresses
Primary practice location
340 Dale St
Unit C
Chicopee, MA 01013-4176
Mailing address
340 Dale St
Unit C
Chicopee, MA 01013-4176
Phone (413) 313-1507
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 |
|---|---|---|---|
| 008073 | CT | MD | Public Health Dentist |
| DH88283 | MA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1659758423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 DALE ST",
"address_2": "UNIT C",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010134176",
"telephone_number": "413-313-1507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 DALE ST",
"address_2": "UNIT C",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010134176",
"telephone_number": "413-313-1507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLASZ",
"first_name": "JENNIFER",
"middle_name": "MARY",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CT",
"license": "008073",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MA",
"license": "DH88283",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicopee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.