Scott L Matson, DMD, BS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8227102-9924 Issued in UT

Practice address

3125 N Main St
#3
North Logan, UT 84341-1547

Phone

(435) 239-7212

Fax

(435) 535-2464

NPI assigned

Apr 15, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 20, 2018 through Nov 20, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1942474440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 N MAIN ST",
            "address_2": "#3",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411547",
            "telephone_number": "435-239-7212",
            "fax_number": "435-535-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 N MAIN ST",
            "address_2": "#3",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411547",
            "telephone_number": "435-239-7212",
            "fax_number": "435-535-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSON",
        "first_name": "SCOTT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD, BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS037272",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "8227102-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in North Logan, UT
• Providers in North Logan, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.