Active NPI
Matthew Ellis Joelson, DDS
- General Practice Dentistry
- Beverly Hills, MI
National Provider Identifier
1790999399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901020341
- Practice address
- 32990 Pierce St
Beverly Hills, MI 48025-3216 - Phone
- (248) 594-3300
- Fax
- (248) 594-3121
- NPI assigned
- May 10, 2007
- Last updated
- Apr 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019026262 | IL | |
| General Practice Dentistry | 1223G0001X | 2901020341 | MI | Primary |
Addresses
Primary practice location
32990 Pierce St
Beverly Hills, MI 48025-3216
Mailing address
32990 Pierce St
Beverly Hills, MI 48025-3216
Phone (248) 594-3300
Other practice location 1
137 N Oak Park Ave
Suite 202
Oak Park, IL 60301-1344
Phone (708) 524-0330
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019026262 | IL | MD | General Practice Dentistry |
| 2901020341 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wesley C. Wise, DDS & Associates, LTD | General Practice | Past | Accepting new patients |
| Murphy Dental Group, PLLC | General Practice | Past | Accepting new patients |
| Pierce Street Dental | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Beverly Hills, MI
- NPI 1851639397
-
- General Practice Dentistry
- Oak Park, IL
- NPI 1184392946
-
- General Practice Dentistry
- Oak Park, IL
- NPI 1114046398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523491200000",
"number": "1790999399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32990 PIERCE ST",
"city": "BEVERLY HILLS",
"state": "MI",
"postal_code": "480253216",
"telephone_number": "248-594-3300",
"fax_number": "248-594-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32990 PIERCE ST",
"city": "BEVERLY HILLS",
"state": "MI",
"postal_code": "480253216",
"telephone_number": "248-594-3300",
"fax_number": "248-594-3121"
}
],
"practiceLocations": [
{
"address_1": "137 N Oak Park Ave",
"address_2": "Suite 202",
"address_purpose": "LOCATION",
"city": "Oak Park",
"state": "IL",
"postal_code": "603011344",
"country_code": "US",
"telephone_number": "708-524-0330",
"fax_number": "708-524-0136",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOELSON",
"first_name": "MATTHEW",
"middle_name": "ELLIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019026262",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901020341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.