Matthew Joseph Costa, D.M.D.Q

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS037507 Issued in PA

Practice address

316 W 4TH St
Quarryville, PA 17566-1138

Phone

(717) 786-2746

NPI assigned

Jun 20, 2008

Sex

Male

Sole proprietor

Yes

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 PA

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

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.

• Brown-McMullen-Wisse Dental Associates, PC.

  • General Practice Dentistry
  • Quarryville, PA
  • NPI 1912121427
  NPD (past) Authorized official

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1962663104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 GOVERNOR MARKHAM DR",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421029",
            "telephone_number": "610-558-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W 4TH ST",
            "city": "QUARRYVILLE",
            "state": "PA",
            "postal_code": "175661138",
            "telephone_number": "717-786-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.Q",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brown-McMullen-Wisse Dental Associates, PC.
• Roger L. Brown, D.D.S.
• Brian T Burke, DMD
• Keriann Nicole Clements
• Linda J. Coates, P.T.
• Stephen Costa, LCSW
• Marco Cunicelli, DO
• Daniel B Neff DPT Physical Therapy PC
• Kristopher Davis, DPT
• Kali Hannah Doyle, LAPC

• General Practice Dentistry in Quarryville, PA
• Providers in Quarryville, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.