Matthew Sandberg, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6664-15 Issued in WI

Practice address

6535 W North Ave
Wauwatosa, WI 53213-2016

Phone

(414) 258-8190

NPI assigned

Apr 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Sandberg Modern Dental LLC

  • General Practice Dentistry
  • Wauwatosa, WI
  • NPI 1285029652
  NPD (past) Authorized official

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

{
    "created_epoch": "1270857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1851617229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132016",
            "telephone_number": "414-258-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132016",
            "telephone_number": "414-258-8190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 W National Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532952016",
            "country_code": "US",
            "telephone_number": "414-384-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "MATTHEW",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-10",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "WI",
            "license": "6664-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6664-15",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6664-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Sanchez, BCBA
• Krista Renee Sanchez, RN
• Naomi Sanchez, LCSW
• Rebecca Sanchez, LPC-IT, SAC-IT
• Sandberg Modern Dental LLC
• Justin Sandver, M.D.
• Hairong Sang, M.D.
• Angie M Santarelli, APNP
• Jose Jesus Santiago-Roque Jr., PA-C
• Logan Alexander Sarge

• Dentist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.