Individual provider Active NPI

Matthew Richard Maley, DDS

  • General Practice Dentistry
  • Toledo, OH
National Provider Identifier
1922105535
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30022123 Issued in OH
Practice address
4352 Sylvania Ave Suite Q
Toledo, OH 43623-3441
Phone
(419) 882-0622
Fax
(419) 882-1701
NPI assigned
Sep 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 30022123 OH Primary

Addresses

Primary practice location

4352 Sylvania Ave Suite Q
Toledo, OH 43623-3441

Mailing address

4352 Sylvania Ave Suite Q
Toledo, OH 43623-3441
Phone (419) 882-0622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150423000102 OH Order and Referring Only - DentistPractitioner - Dentist 2365760394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30022123OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922105535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4352 SYLVANIA AVE SUITE Q",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233441",
            "telephone_number": "419-882-0622",
            "fax_number": "419-882-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 SYLVANIA AVE SUITE Q",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233441",
            "telephone_number": "419-882-0622",
            "fax_number": "419-882-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEY",
        "first_name": "MATTHEW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.