Active NPI
Shawn Matian, D.D.S.
- General Practice Dentistry
- Reseda, CA
National Provider Identifier
1710138110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 57773
- Practice address
- 18701 Sherman Way
Suite 3
Reseda, CA 91335-4045 - Phone
- (818) 521-2222
- NPI assigned
- Oct 2, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 57773 | CA | Primary |
Addresses
Primary practice location
18701 Sherman Way
Suite 3
Reseda, CA 91335-4045
Mailing address
18701 Sherman Way
Suite 3
Reseda, CA 91335-4045
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 |
|---|---|---|---|---|
| I20170623002519 | CA | Order and Referring Only - Dentist | 7214205749 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matian Dental Partners | Current | Accepting new patients | |
| Matian DDS Inc | Past | Accepting new patients | |
| Matian DDS Inc | Past | Accepting new patients |
Organizations & group practices 3
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 Clinic/Center
- Agoura Hills, CA
- NPI 1245129154
-
- Dentist
- Reseda, CA
- NPI 1083058705
-
- Dental Clinic/Center
- Reseda, CA
- NPI 1992946206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1710138110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18701 SHERMAN WAY",
"address_2": "SUITE 3",
"city": "RESEDA",
"state": "CA",
"postal_code": "913354045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18701 SHERMAN WAY",
"address_2": "SUITE 3",
"city": "RESEDA",
"state": "CA",
"postal_code": "913354045",
"telephone_number": "818-521-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATIAN",
"first_name": "SHAWN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "57773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Reseda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.