Individual provider Active NPI

Matthew Charles Kolar, D.D.S.

  • General Practice Dentistry
  • Quanah, TX
National Provider Identifier
1891073847
Registry record updated Aug 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27277 Issued in TX
Practice address
104 W 3Rd St
Quanah, TX 79252-4034
Phone
(940) 663-5353
Fax
(940) 663-5911
NPI assigned
Jul 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2012

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 27277 TX Primary

Addresses

Primary practice location

104 W 3Rd St
Quanah, TX 79252-4034

Mailing address

PO Box 486
Quanah, TX 79252-0486
Phone (940) 663-5353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151214000573 TX Order and Referring Only - DentistPractitioner - Dentist 2860793098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27277TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew C Kolar DDS PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345593600000",
    "number": "1891073847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 486",
            "city": "QUANAH",
            "state": "TX",
            "postal_code": "792520486",
            "telephone_number": "940-663-5353",
            "fax_number": "940-663-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 3RD ST",
            "city": "QUANAH",
            "state": "TX",
            "postal_code": "792524034",
            "telephone_number": "940-663-5353",
            "fax_number": "940-663-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAR",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-25",
        "last_updated": "2012-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quanah, TX

Sources for this page

Verify at the official NPI Registry.