Gary David Matt, D.D.S.M.S.

Primary specialty

DentistTaxonomy code 122300000X

License

7953 Issued in IA

Practice address

1450 28TH St
West Des Moines, IA 50266-1430

Phone

(515) 224-4455

Fax

(515) 224-4040

NPI assigned

Sep 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Endodontics, P.C.

  • Endodontics
  • West Des Moines, IA
  • NPI 1114053857
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1801083753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 28TH ST",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661430",
            "telephone_number": "515-224-4455",
            "fax_number": "515-224-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 28TH ST",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661430",
            "telephone_number": "515-224-4455",
            "fax_number": "515-224-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATT",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "7953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas W Massop, M.D.
• Mitchell S Masters, SLP
• Mary Michelle Masterson, A.R.N.P.
• Jenifer Jo Mathers, P.T.A.
• Mely Mary Mathew, M.D
• Matthew Kubovich
• Kathleen Carey Matthews, PH.D.
• Katherine Maurer, MPT
• Maxim Healthcare Services, Inc.
• Timothy P Mayfield, MD

• Dentist in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.