Matthew Joseph Heinz, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019.035975 Issued in IL

Practice address

312 Center St
Lake Geneva, WI 53147-1904

Phone

(262) 248-8766

NPI assigned

Jun 21, 2020

Sex

Male

Sole proprietor

No

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

Enrolled in CA

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lake Geneva Oral and Maxillofacial Surgery, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Geneva, WI
  • NPI 1063420206
  NPD

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

{
    "created_epoch": "1592697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1972129427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 EVERGREEN LN",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531479708",
            "telephone_number": "262-903-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 CENTER ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471904",
            "telephone_number": "262-248-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-825-0834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "690 N Route 31, State Rte 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "60012",
            "country_code": "US",
            "telephone_number": "815-459-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-21",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105787",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.035975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Ann Gursky, DPT
• Susan M Hagnell, MD
• Volha Haliantava, M.D.
• Christopher John Hanson, DO
• Normajean L Harness
• Kathryn Hepner, LPC, NCC
• Hanna M Herland, OT
• Emma Jeanette Hervat, DC
• Courtney A. Hlavinka, APNP
• Matthew Allen Hoffman, P.T.

• Oral and Maxillofacial Surgery (Dentist) in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.