MR. CHARLES KENNETH DEMATTE JR. (NPI# 1578601498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578601498 |
| Entity Type | Individual |
| Full Name | MR. CHARLES KENNETH DEMATTE JR. |
| Credential | DDS |
| Practice Address |
334 Main Street Bridgeport OH 43912 |
| Practice Telephone | 7406352567 |
| Practice Fax Number | 7406351976 |
| Mailing Telephone | 7406352567 |
| Mailing Fax Number | 7406351976 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
15334 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0604019 | 05 |
| Street Address |
334 MAIN STREET |
| City | BRIDGEPORT |
| State | OH |
| Zip Code | 43912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321044 | Linda L Link | Private Vehicle | 53205 Poplar Drive, Stobbs Estates, Bridgeport, OH 43912 | 2020-09-16 |
| 1427604339 | Tammy Sue Cox | Behavior Technician | 68583 Scott Street, Bridgeport, OH 43912 | 2019-08-15 |
| 1891056750 | Amy Snedeker | Intermediate Care Facility, Mental Illness | 68181 Neola Avenue, Bridgeport, OH 43912 | 2012-06-06 |
| 1790064111 | Tiffanie M Patton | Home Health Aide | 69395 Sunset Heights, Bridgeport, OH 43912 | 2011-08-16 |
| 1841415247 | Doris Ann Newman | Nurse's Aide | 56362 Berkley Avenue, Bridgeport, OH 43912 | 2007-04-13 |
| 1689732778 | Gerald C Booth | Chiropractor | 56104 National Road, Suite 112a, Bridgeport, OH 43912 | 2006-12-04 |
| 1578646808 | Fausto J Lazo | Family Medicine | 55741 National Rd, Bridgeport, OH 43912 | 2006-10-23 |
| 1225144108 | Riesbeck Food Markets, Inc. | Pharmacy | 56130 National Road, Bridgeport, OH 43912 | 2006-08-22 |
| 1487609558 | Keith A Poole | Family Medicine | 55741 National Road, Bridgeport, OH 43912 | 2006-05-24 |
| 1285605329 | Peter Eugene Perzanowski | Chiropractor | 300 Howard St, Ste 2, Bridgeport, OH 43912 | 2006-01-27 |
| Find all providers in zip 43912 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891355814 | Kristopher Antonio Yen | Dentist | 32 Kathryn Dr, Bridgeport, CT 06610-1264 | 2019-06-20 |
| 1407239379 | Oliver Sun | Dentist | 3885 Main St Ste 101, Bridgeport, CT 06606-2814 | 2015-07-09 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1588064349 | Siz, LLC | Dentist | 1041-1043 East Main Street, Bridgeport, CT 06608-1916 | 2014-08-29 |
| 1306269758 | Dr.dental of Bridgeport PC | Dentist | 1700 Park Ave., Bridgeport, CT 06604-3826 | 2014-01-21 |
| 1700144714 | Hamed Ghorbani-moghaddam | Dentist | 2690 E Main St, Columbia Dental, Bridgeport, CT 06610-1422 | 2012-04-26 |
| 1831476050 | Dental Centers of Fairfiled County LLC | Dentist | 140 Hurd Ave, Bridgeport, CT 06604-2701 | 2011-11-16 |
| 1124308184 | Family Dentistry of Bridgeport P.C. | Dentist | 90 Brooklawn Ave, Bridgeport, CT 06604-2010 | 2011-08-23 |
| 1861789034 | Bridgeport Dental Care, LLC | Dentist | 2417 E Main St, Bridgeport, CT 06610-1802 | 2011-07-07 |
| 1154628477 | Bridgeport Dentist | Dentist | 2992 Main St, Bridgeport, CT 06606-4226 | 2011-02-23 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 43912 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.