Individual provider Active NPI

Matthew Bieber, DDS

  • General Practice Dentistry
  • Clear Lake, IA
National Provider Identifier
1780200543
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS-09784 Issued in IA
Practice address
102 N 5TH St
Clear Lake, IA 50428-1803
Phone
(641) 357-4112
Fax
(641) 357-0670
NPI assigned
Jun 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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 DDS-09784 IA Primary

Addresses

Primary practice location

102 N 5TH St
Clear Lake, IA 50428-1803

Mailing address

102 N 5TH St
Clear Lake, IA 50428-1803
Phone (641) 357-4112

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
DDS-09784IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bieber Dental PLLC CurrentSince Dec 24, 2023 Accepting new patients
Lake Dental Associates PC General Practice PastSince Jun 21, 2020 Accepting new patients

Locations

102 N 5th St
Clear Lake, IA 50428
Phone (641) 357-4112

Organizations & group practices 2

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1780200543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N 5TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281803",
            "telephone_number": "641-357-4112",
            "fax_number": "641-357-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N 5TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281803",
            "telephone_number": "641-357-4112",
            "fax_number": "641-357-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIEBER",
        "first_name": "MATTHEW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clear Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.