Individual provider Active NPI

Matthew Alan Novak, D.M.D.

  • Dentist
  • Rhinelander, WI
National Provider Identifier
1811344237
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1001402 Issued in WI
Practice address
2268 N Shore Dr
Rhinelander, WI 54501-8888
Phone
(715) 420-1400
NPI assigned
May 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001402 WI Primary

Addresses

Primary practice location

2268 N Shore Dr
Rhinelander, WI 54501-8888

Mailing address

2268 N Shore Dr
Rhinelander, WI 54501-8888
Phone (715) 420-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20160921000126 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2163719071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001402WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1811344237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2268 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018888",
            "telephone_number": "715-420-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018888",
            "telephone_number": "715-420-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinelander, WI

Sources for this page

Verify at the official NPI Registry.