Matchstick LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2009013643 Issued in MO

Legal business name

MATCHSTICK LLC

Doing business as

DaVinci Dental Care

Practice address

2401 Bernadette Dr
Suite 217
Columbia, MO 65203-4672

Phone

(573) 445-1100

Fax

(573) 445-1153

NPI assigned

Aug 3, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Virginia Gadbois, DDS

Title

Chief Financial Officer

Phone

(573) 446-0880

Specialties & licenses 1

Addresses

Other names 1

• DaVinci Dental Care Doing business as

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1982918884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 VAWTER SCHOOL RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039418",
            "telephone_number": "573-445-1100",
            "fax_number": "573-445-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BERNADETTE DR",
            "address_2": "SUITE 217",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034672",
            "telephone_number": "573-445-1100",
            "fax_number": "573-445-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATCHSTICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "GADBOIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "573-446-0880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2009013643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVinci Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Marie Maskeri, MD
• Jessica Mason, PHARMD
• Faizan Masood
• Breona Massey
• Kyle Massey
• Delia A Matias I, M.D.
• Madison Matney, MA, PLPC
• Devin Matteoni, DO
• Michelle L Matteson-Kome, FNP/GNP
• Matthew Concannon LLC

• General Practice Dentistry in Columbia, MO
• Providers in Columbia, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.