Lauren Gutta Matini, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401415659 Issued in VA

Practice address

13801 Heathcote Blvd
100
Gainesville, VA 20155

Phone

(571) 222-6042

NPI assigned

Jun 14, 2017

Last updated

Jul 21, 2022By the provider in NPPES

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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.

• Lauren G. Matini DDS PLLC

  • Dental Clinic/Center
  • Great Falls, VA
  • NPI 1669332656
  NPD Authorized official
• Dental Professionals of Virginia, P.C

  dba Little Bull Run Dental

  • General Practice Dentistry
  • Gainesville, VA
  • NPI 1346770682
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952831745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 HEATHCOTE BLVD",
            "address_2": "100",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "571-222-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 HEATHCOTE BLVD",
            "address_2": "100",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "571-222-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATINI",
        "first_name": "LAUREN",
        "middle_name": "GUTTA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert L Marsh, M.D.
• Christy Elizabeth Maxwell, FNP
• Jenna Hazel McBride
• Dwayne Eric McClerklin, MD
• Doug McCracken
• Alexis Ciccone McCullough

• Dentist in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.