Individual provider Active NPI

Matthew Kiernan, DMD

  • General Practice Dentistry
  • Lexington, MA
National Provider Identifier
1881322113
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1859555 Issued in MA
Practice address
922 Waltham St Ste 205
Lexington, MA 02421-8019
Phone
(781) 861-1444
NPI assigned
Aug 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1859555 MA Primary

Addresses

Primary practice location

922 Waltham St Ste 205
Lexington, MA 02421-8019

Mailing address

922 Waltham St Ste 205
Lexington, MA 02421-8019
Phone (781) 861-1444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN1859555MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Dental Care Matthew R Kiernan DMD LLC General Practice CurrentSince Jan 19, 2025 Accepting new patients
Lexington Dental Care, Brenda J Nishimura, DDS, LLC General Practice PastSince Jan 19, 2025 Accepting new patients

Locations

922 Waltham St
Ste 205
Lexington, MA 02421
Phone (781) 861-1444

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1660435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1881322113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 WALTHAM ST STE 205",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218019",
            "telephone_number": "781-861-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 WALTHAM ST STE 205",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218019",
            "telephone_number": "781-861-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-14",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1859555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.