Matthew Steven Carmien, D.D.S.

Individual provider Active NPI General Practice Dentistry · Plymouth, IN

NPI 1669819215 · NPPES record last updated Sep 19, 2024

Key facts

NPI
1669819215
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12011942A (IN)
Practice address
850 Columbus Dr
Plymouth, IN 46563-1877
Phone
(574) 936-2527
NPI assigned
May 22, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12011942AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carmien & Pedavoli Family Dentistry, LLC General Practice Current
since Sep 23, 2024
Accepting new patients
Dental Health P.C. General Practice Past Accepting new patients
Thomas M. Pedavoli DDS Inc. Dentist Past
since Sep 23, 2024
Accepting new patients

Locations

850 Columbus Dr
Plymouth, IN 46563
Phone (574) 936-2527

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011942A IN
General Practice Dentistry 1223G0001X 12011942A IN Yes

Addresses

Primary practice location

850 Columbus Dr
Plymouth, IN 46563-1877

Mailing address

850 Columbus Dr
Plymouth, IN 46563-1877
Phone (574) 936-2527

Other providers in Plymouth, IN

All providers in Plymouth, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.