Nicholas Mattila, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7014-15 Issued in WI

Practice address

1711 Shawano Ave
Green Bay, WI 54303-3215

Phone

(920) 494-9541

Fax

(920) 494-2026

NPI assigned

May 28, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dental Arts Associates of Green Bay LTD

  • Dental Clinic/Center
  • Green Bay, WI
  • NPI 1326173006
  NPD (past)

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1700105806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033215",
            "telephone_number": "920-494-9541",
            "fax_number": "920-494-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033215",
            "telephone_number": "920-494-9541",
            "fax_number": "920-494-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTILA",
        "first_name": "NICHOLAS",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "7014-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Mathwig
• Jodi Ann Mathys, MSE, LPC
• Matrix World Organization Inc
• Allison Matthews, PA-C
• Frank R Mattia, MD
• Kalli Mattson
• Samantha Matuszak
• Michelle Maxfield, PT
• Kimberly M Maxson, APNP
• Jordan Maxwell

• General Practice Dentistry in Green Bay, WI
• Providers in Green Bay, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.