Matthew James Coon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6759 Issued in NE

Practice address

1617 17TH Ave
Central City, NE 68826-1711

Phone

(308) 946-3841

NPI assigned

Sep 8, 2009

Last updated

Sep 7, 2023By 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 1

Addresses

Other identifiers 2

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 Jun 1, 2016 through Jun 1, 2028

Medicare enrollment (NPD)

Not 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.

• Family First Dental Associates of West Point, P.C.

  dba Family 1st Dental of Central City

  • General Practice Dentistry
  • Central City, NE
  • NPI 1215160601
  NPD (past)

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1962735035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 SAGE ST",
            "city": "GERING",
            "state": "NE",
            "postal_code": "693413229",
            "telephone_number": "308-436-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 17TH AVE",
            "city": "CENTRAL CITY",
            "state": "NE",
            "postal_code": "688261711",
            "telephone_number": "308-946-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-08",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "05514",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METLIFE",
            "identifier": "109685",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central City Opco LLC (Adept Nursing & Rehab of Central City)
• Central Transport LLC
• City of Central City (Central City Ambulance Service)
• Jeff F. Clarke, D.D.S
• Brenda Marie Cole
• Cor Therapeutic Services, LLC
• Cottonwood Business LLC
• Cottonwood Estates LLC
• Traci A Dieckmann, D.O.
• Amanda J Dinneen, COTA

• Dentist in Central City, NE
• Providers in Central City, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.