Active NPI
Jeff Matilsky, D.M.D.
- Dentist
- Gainesville, FL
National Provider Identifier
1699182196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN0012454
- Practice address
- 2251 NW 41St St Ste 40
Gainesville, FL 32606-6668 - Phone
- (352) 376-4637
- NPI assigned
- Jul 16, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN0012454 | FL | Primary |
Addresses
Primary practice location
2251 NW 41St St Ste 40
Gainesville, FL 32606-6668
Mailing address
2251 NW 41St St Ste 40
Gainesville, FL 32606-6668
Phone (352) 376-4637
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 |
|---|---|---|---|
| DN0012454 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeff R Matilsky DMD PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Gainesville, FL
- NPI 1033212451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1699182196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 NW 41ST ST STE 40",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326066668",
"telephone_number": "352-376-4637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2251 NW 41ST ST STE 40",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326066668",
"telephone_number": "352-376-4637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATILSKY",
"first_name": "JEFF",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-16",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN0012454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.