Marilyn Betty Mathew, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001024-15 Issued in WI

Practice address

751 Mallet Hill Rd
Apt 4208
Columbia, SC 29223-4471

Phone

(845) 702-0581

NPI assigned

Jun 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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.

• Ingleside Family Dental, LLC

  • General Practice Dentistry
  • Ladson, SC
  • NPI 1174159248

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1831483650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 MALLET HILL RD",
            "address_2": "APT 4208",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234471",
            "telephone_number": "845-702-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 MALLET HILL RD",
            "address_2": "APT 4208",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234471",
            "telephone_number": "845-702-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MARILYN",
        "middle_name": "BETTY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001024-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831483650",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yoshua Mathai
• Erin Mathena, LPC, LCMHC, NCC
• Andrew Roscoe Mather, M.D.
• Christina Mather, PHARMD.
• Katherine Matheson
• Candler Grady Mathews III
• Harvey Wells Mathews, PT, OCS
• Moncy Mathews
• Lyndsey Hughes Mathias, NP-C
• Tiesha Keoni Mathis, APRN

• All providers in Columbia, SC
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.