Matthew Edward Dudziak, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

73 Issued in CA

Practice address

8112 Milliken Ave
Suite 102
Rancho Cucamonga, CA 91730-7471

Phone

(909) 581-7761

Fax

(909) 581-7766

NPI assigned

Mar 30, 2007

Last updated

Mar 6, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inland Empire Oral and Maxillofacial Surgeons

  • Oral and Maxillofacial Surgery (Dentist)
  • Rancho Cucamonga, CA
  • NPI 1245497932
  NPD (past) Authorized official

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1922128321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 MILLIKEN AVE",
            "address_2": "SUITE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307471",
            "telephone_number": "909-581-7761",
            "fax_number": "909-581-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 MILLIKEN AVE",
            "address_2": "SUITE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307471",
            "telephone_number": "909-581-7761",
            "fax_number": "909-581-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDZIAK",
        "first_name": "MATTHEW",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "5440",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "73",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "MD428786",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A98904",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "LA",
            "license": "MD200551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandie Dubois
• Reyna Duchene
• Chasity Monet Ducre
• Krista Duda
• Tashanaye Dudley
• Lilyan Duenez
• Sandra Gayle Duffield
• Ronald Mark Dugan, DDS
• Krystal N Duhaney, RN, IBCLC
• Dunamis Care Inc

• Oral and Maxillofacial Surgery (Dentist) in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.