DR. KEVIN TODD MATHEWSON DDS NPI 1912072919

NPI Information

NPI: 1912072919
Provider Name: DR. KEVIN TODD MATHEWSON, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
415 SOUTH STATE STREET
BIG RAPIDS, MI
ZIP 49307
Phone: (231) 796-3571
Get Directions

DR. Kevin Todd Mathewson, DDS is a general practice dentist in Big Rapids, MI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Kevin Todd Mathewson, DDS NPI is 1912072919. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

415 SOUTH STATE STREET
BIG RAPIDS, MI
ZIP 49307-049
Phone: (231) 796-3571
Fax: (231) 796-2211

The NPI 1912072919 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/22/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	29010-16945	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3317643	OTHER	MICHIGAN	MEDICAID
2	D169450	OTHER	MICHIGAN	BCBS
3	3272864	MEDICAID	MICHIGAN
4	971753	OTHER	MICHIGAN	UNITED CONCORDIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »