Active NPI
Robert Andrew Matthews, DMD
- General Practice Dentistry
- Merritt Island, FL
National Provider Identifier
1679664288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN007300
- Practice address
- 3345 N Courtenay Parkway
Suite 105
Merritt Island, FL 32953 - Phone
- (321) 986-8686
- Fax
- (321) 986-8688
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN007300 | FL | Primary |
Addresses
Primary practice location
3345 N Courtenay Parkway
Suite 105
Merritt Island, FL 32953
Mailing address
1295 Mosswood CT
Indialantic, FL 32903
Phone (321) 986-8686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3500268 | Medicaid | FL |
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 |
|---|---|---|---|
| DN007300 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679664288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1295 MOSSWOOD CT",
"city": "INDIALANTIC",
"state": "FL",
"postal_code": "32903",
"telephone_number": "321-986-8686",
"fax_number": "321-986-8688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3345 N COURTENAY PARKWAY",
"address_2": "SUITE 105",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "32953",
"telephone_number": "321-986-8686",
"fax_number": "321-986-8688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "ROBERT",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN007300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3500268",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.