Active NPI
Dewayne Anthony Matthews, D.D.S.
- Dentist
- Chicopee, MA
National Provider Identifier
1992069041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL13170
- Practice address
- 505 Front St
Chicopee, MA 01013-3140 - Phone
- (413) 420-6233
- NPI assigned
- Jul 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DL13170 | MA | Primary |
| Dentist | 122300000X | 110134 | CT |
Addresses
Primary practice location
505 Front St
Chicopee, MA 01013-3140
Mailing address
505 Front St
Chicopee, MA 01013-3140
Phone (413) 420-6233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190117002117 | MA | Order and Referring Only - Dentist | 9133465735 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110134 | CT | MD | Dentist |
| DL13170 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1992069041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 FRONT ST",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010133140",
"telephone_number": "413-420-6233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 FRONT ST",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010133140",
"telephone_number": "413-420-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "DEWAYNE",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-03",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL13170",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "110134",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicopee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.