Individual provider Active NPI

Shawn Matian, D.D.S.

  • General Practice Dentistry
  • Reseda, CA
National Provider Identifier
1710138110
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57773 Issued in CA
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

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623002519 CA Order and Referring Only - DentistPractitioner - Dentist 7214205749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.