Matthew S Cantner, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

9294 Issued in CT

Practice address

97 Elm St
Old Saybrook, CT 06475-4106

Phone

(860) 388-4439

Fax

(860) 938-8449

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 CT

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

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871507798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 JERICHO DR",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711326",
            "telephone_number": "860-434-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754106",
            "telephone_number": "860-388-4439",
            "fax_number": "860-938-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTNER",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "9294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Burnett
• Courtney Leigh Bushnell, LCSW
• Pamela Caehill, PSY.D.
• Callie Lamay DPM LLC
• Ira Leroy Cantner II, D.M.D.
• Caring Ways Adult Day Center
• Carla Harper, LPC, LLC
• Carolyn Koerner Mangiafico LLC
• Carrie Kolb, LCSW, LLC
• John T Carroll, DPM

• Periodontics in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.