Active NPI
Matthew Macginnis, D.D.S., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fullerton, CA
National Provider Identifier
1669736385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 58509
- Practice address
- 333 W Bastanchury Rd
Fullerton, CA 92835-3433 - Phone
- (714) 253-5333
- NPI assigned
- Jun 27, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 58509 | CA | Primary |
Addresses
Primary practice location
333 W Bastanchury Rd
Fullerton, CA 92835-3433
Mailing address
2553 N Glen Canyon Rd
Orange, CA 92867-2101
Phone (714) 345-4602
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58509 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340755200000",
"number": "1669736385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2553 N GLEN CANYON RD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928672101",
"telephone_number": "714-345-4602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 W BASTANCHURY RD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353433",
"telephone_number": "714-253-5333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACGINNIS",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-27",
"last_updated": "2012-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "58509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.