Individual provider Active NPI

Matthew Ryan Sperber, DDS

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1710482773
Registry record updated Jun 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9332 Issued in SC
Practice address
2015 2ND Ave Ste 201
Summerville, SC 29486-7889
Phone
(843) 900-4428
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 9332 SC Primary

Addresses

Primary practice location

2015 2ND Ave Ste 201
Summerville, SC 29486-7889

Mailing address

2015 2ND Ave Ste 201
Summerville, SC 29486-7889
Phone (843) 900-4428

Other practice location 1

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7642

Other practice location 2

1204 Two Island Ct
Mount Pleasant, SC 29466
Phone (843) 881-8881

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

LicenseStateTypeSpecialty
9332SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Family Dental LLC General Practice CurrentSince Jul 4, 2021 Accepting new patients
Riccobene & Associates CCC, DDS, PC General Practice CurrentSince Mar 20, 2025 Accepting new patients
Pleasant Family Dentistry General Practice PastSince Aug 1, 2019 Accepting new patients

Locations

1204 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 881-8881

2015 2nd Ave
Ste 201
Summerville, SC 29486
Phone (516) 521-3012

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1710482773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 2ND AVE STE 201",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867889",
            "telephone_number": "843-900-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 2ND AVE STE 201",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867889",
            "telephone_number": "843-900-4428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Lyons Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071122027",
            "country_code": "US",
            "telephone_number": "973-926-7642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1204 Two Island Ct",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "29466",
            "country_code": "US",
            "telephone_number": "843-881-8881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPERBER",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; 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.