Individual provider Active NPI

Matthew J Muir

  • General Practice Dentistry
  • Mustang, OK
National Provider Identifier
1669097077
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
T-7343 Issued in OK
Practice address
1001 E State Highway 152 Ste 113
Mustang, OK 73064-5131
Phone
(405) 353-1388
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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 T-7343 OK Primary

Addresses

Primary practice location

1001 E State Highway 152 Ste 113
Mustang, OK 73064-5131

Mailing address

1001 E State Highway 152 Ste 113
Mustang, OK 73064-5131
Phone (405) 353-1388

Other practice location 1

901 E Main St
Ste 100
Yukon, OK 73099
Phone (405) 493-0830

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.mustangdentistry.com Direct

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
T-7343OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mustang Dentistry & Braces CurrentSince Nov 1, 2020 Accepting new patients
Yukon Dentistry & Braces PastSince Aug 30, 2020 Accepting new patients

Locations

1001 E State Highway 152
Ste 113
Mustang, OK 73064
Phone (405) 353-1388

Organizations & group practices 2

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1669097077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E STATE HIGHWAY 152 STE 113",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645131",
            "telephone_number": "405-353-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E STATE HIGHWAY 152 STE 113",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645131",
            "telephone_number": "405-353-1388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Main St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Yukon",
            "state": "OK",
            "postal_code": "73099",
            "country_code": "US",
            "telephone_number": "405-493-0830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUIR",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "T-7343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mustangdentistry.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1001 E State Highway 152 Ste 113",
            "city": "Mustang",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730645131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mustang, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.