Michel Matouk, M.D.,DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN15692 Issued in FL

Practice address

2600 E Commercial Blvd
Suite 200
Ft Lauderdale, FL 33308-4125

Phone

(954) 566-0300

Fax

(954) 566-9066

NPI assigned

Jun 1, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2022 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1669419461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E COMMERCIAL BLVD",
            "address_2": "SUITE 200",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084125",
            "telephone_number": "954-566-0300",
            "fax_number": "954-566-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E COMMERCIAL BLVD",
            "address_2": "SUITE 200",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084125",
            "telephone_number": "954-566-0300",
            "fax_number": "954-566-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOUK",
        "first_name": "MICHEL",
        "name_prefix": "Dr.",
        "credential": "M.D.,DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN15692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smitha Mathew, PHARMD
• Jean-Wilner Mathieu, M.D.
• Phyllis Rena Mathis
• Matias Nemetz Matias, DO
• Alexandra Matos
• Peter V. Matrale, D.C.
• Eva Carmen Mattei, LMHC
• Christopher Adam Matthews
• Christina Diane Mattingly, MD
• Richard Peter Maulion, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.