Individual provider Active NPI

Matthew Ellis Joelson, DDS

  • General Practice Dentistry
  • Beverly Hills, MI
National Provider Identifier
1790999399
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020341 Issued in MI
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, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
019026262ILMDGeneral Practice Dentistry
2901020341MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley C. Wise, DDS & Associates, LTD General Practice Past Accepting new patients
Murphy Dental Group, PLLC General Practice PastSince Sep 12, 2021 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.

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.

Verify at the official NPI Registry.