Matthew Neill Zimmer

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10269 Issued in NC

Practice address

100 Nicolls Rd
114 Rockland Hall
Stony Brook, NY 11794

Phone

(631) 632-3181

NPI assigned

Apr 10, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1972922599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CAMPANILE DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178605",
            "telephone_number": "631-327-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD",
            "address_2": "114 ROCKLAND HALL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-632-3181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Nicolls Rd",
            "address_2": "114 Rockland Hall",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948701",
            "country_code": "US",
            "telephone_number": "631-632-3181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "MATTHEW",
        "middle_name": "NEILL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "10269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina Zheng, DO
• Yuejiao Zheng
• Meredith Zhou, DDS
• Olivia Tao Zhou, MD
• Liang Zhuo
• Jaclyn Michelle Zito, PA-C
• David Bin Yomin Zlochower, MD
• Shabnam Zoeb, D.O.
• Tirajeh Zohourian, MD
• Desirie M Zorn, NP

• Pediatric Dentistry in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.