Active NPI
Matthew R Winkle, DDS
- Dentist
- Redway, CA
National Provider Identifier
1689764136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D8627
- Practice address
- 101 West Coast Road
Redwoods Rural Health Center
Redway, CA 95560 - Phone
- (707) 923-2783
- Fax
- (707) 923-1688
- NPI assigned
- Oct 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D8627 | OR | Primary |
| Dentist | 122300000X | 60013 | CA |
Addresses
Primary practice location
101 West Coast Road
Redwoods Rural Health Center
Redway, CA 95560
Mailing address
PO Box 769
Redwoods Rural Health Clinic
Redway, CA 95560-0769
Phone (707) 923-2783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130730000073 | CA | Order and Referring Only - Oral Surgery | 3476794769 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8627 | OR | MD | Dentist |
| 60013 | CA | MD | Pharmacist |
Interoperability endpoints
- lorraine.prisbreydds.p1@direct.rrhc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1689764136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 769",
"address_2": "REDWOODS RURAL HEALTH CLINIC",
"city": "REDWAY",
"state": "CA",
"postal_code": "955600769",
"telephone_number": "707-923-2783",
"fax_number": "707-923-1688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WEST COAST ROAD",
"address_2": "REDWOODS RURAL HEALTH CENTER",
"city": "REDWAY",
"state": "CA",
"postal_code": "95560",
"telephone_number": "707-923-2783",
"fax_number": "707-923-1688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINKLE",
"first_name": "MATTHEW",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D8627",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "60013",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.