Matthew Ticola DMD LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D0005747-C Issued in AL

Legal business name

MATTHEW TICOLA DMD LLC

Practice address

11521 US Highway 431 Ste V
Guntersville, AL 35976-5671

Phone

(256) 505-8954

NPI assigned

May 17, 2017

Last updated

May 17, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew TicolaNPI 1346387644

Title

Manager

Phone

(256) 505-8954

Specialties & licenses 1

Addresses

Other names 1

• Little Critters Pediatric Dentistry Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Paul Ticola, DMD

  • Pediatric Dentistry
  • Guntersville, AL
  • NPI 1346387644
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494979200000",
    "number": "1699202960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11521 US HIGHWAY 431 STE V",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359765671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 US HIGHWAY 431 STE V",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359765671",
            "telephone_number": "256-505-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW TICOLA DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-05-17",
        "status": "A",
        "authorized_official_last_name": "TICOLA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "256-505-8954"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "D0005747-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Critters Pediatric Dentistry",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Little Critters Pediatric Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James L. Masdon, M.D.
• Amy Mason, RN
• Phillip Wilson Mason, R.P.H
• Lori Marie Mathews, BSW
• Jonathan Douglas Matlock, D.O.
• Jubal Matthews, D.C.
• Shannon Matthews, MS,OTR/L
• Tara Ann Kelly Mattox, MSN, RN
• Amanda Mischelle Maynard, BSW
• Bernice Maze, LCSW

• Pediatric Dentistry in Guntersville, AL
• Providers in Guntersville, AL by specialty
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.