Donna Jean Mattscheck, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D11107 Issued in MN

Practice address

11800 Aberdeen St NE
#140
Blaine, MN 55449-4808

Phone

(763) 772-0330

NPI assigned

Oct 12, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 2, 2015 through Jun 2, 2027

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Northland Endodontics PA

  • Endodontics
  • Blaine, MN
  • NPI 1932200037
  NPD (past)
• Scott L. Barry, DMD, PC

  • Endodontics
  • Portland, OR
  • NPI 1396259040
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932298460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WASHINGTON AVE N",
            "address_2": "#308",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ABERDEEN ST NE",
            "address_2": "#140",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494808",
            "telephone_number": "763-772-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSCHECK",
        "first_name": "DONNA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Martin, DPT
• Josa James Martin, DPT
• Lexi Martinez, MPS, LPCC, LADC
• Sarah Elizabeth Gordon Masrud, M.D.
• David Matson, MD
• Carly L. Mattson, PT
• Quinn Antonia Marie Mavetz, MA
• Maxton Agency LLC
• Maxton Agency LLC
• Muthiaru Mugethe Mburu, PHARMD

• Endodontics in Blaine, MN
• Providers in Blaine, MN by specialty
• Endodontics in Minnesota

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.