DR. MATTHEW RUSSEL CHECKETTS (NPI# 1730477084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730477084 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW RUSSEL CHECKETTS |
| Credential | D.D.S. |
| Practice Address |
2133 Pepperrell St Lackland Afb TX 78236-5313 |
| Mailing Address |
307 Boatner Rd Ste 114 Eglin Afb FL 32542-1302 |
| Practice Telephone | 2102928612 |
| Mailing Telephone | 8508838348 |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
00010468 | CO | Dental Providers |
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
10468 | CO | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 782344504 | 2102928612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518344753 | Matthew Glen Checketts | Internal Medicine | 1610 W Townline St, Creston, IA 50801-1066 | 2015-04-27 |
| 1023373305 | Matthew Brent Checketts | Social Worker | 1776 S Main St, Salt Lake City, UT 84115-1951 | 2012-07-12 |
| Street Address |
2133 PEPPERRELL ST |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-5313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770137762 | Casey Danielle Goss | Dentist | 2133 Pepperrell St, Lackland Afb, TX 78236-5313 | 2019-07-29 |
| 1649752841 | Daniel Cooper Lee Jr. | Dentist | 2133 Pepperrell St, Lackland Afb, TX 78236-5313 | 2018-09-04 |
| 1285924407 | Hannah Colburn Drew | Dentist | 2133 Pepperrell St, Bldg 3352, 59 Dg - Afpds, Lackland Afb, TX 78236-5313 | 2011-04-08 |
| 1588865943 | Demitri Villarreal | Dentist | 2133 Pepperrell St, Lackland Afb, TX 78236-5313 | 2007-05-31 |
| 1891706529 | Kelly James Johnson | Dentist | 2133 Pepperrell St, Lackland Afb, TX 78236-5313 | 2006-08-10 |
| 1871528513 | Richard Charles Batzer Jr. | Dentist | 2133 Pepperrell St, Building 3352, Lackland Afb, TX 78236-5313 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447467089 | James Matson Piper II | Dentist | 59dts Mrde, 2450 Pepperrell Street, Lackland Afb, TX 78236-5345 | 2007-05-16 |
| 1871528513 | Richard Charles Batzer Jr. | Dentist | 2133 Pepperrell St, Building 3352, Lackland Afb, TX 78236-5313 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386779 | Daniela Rubiano Mejia | Dentist | 505 W Louis Henna Blvd Ste 505, Austin, TX 78728-1701 | 2020-11-05 |
| 1235738527 | Lorena Malpica | Dentist | 5602 Presidio Pkwy Apt 1411, San Antonio, TX 78249-3093 | 2020-10-19 |
| 1922606870 | Luciano Retana | Dentist | 1235 Kinwest Pkwy, Irving, TX 75063-3403 | 2020-10-13 |
| 1295332393 | Jonathan P Hawley | Dentist | 2423 Barrow St, Abilene, TX 79605-6203 | 2020-10-02 |
| 1629684402 | Ramon Noel Hernandez | Dentist | 13000 N Interstate 35 Ste 206, Austin, TX 78753-1030 | 2020-09-17 |
| 1720697600 | Silvia Sobrecueva | Dentist | 4724 Sweetwater Blvd Ste 103, Sugar Land, TX 77479-3150 | 2020-07-27 |
| 1922620400 | Luis Herra | Dentist | 3838 N Braeswood Blvd Apt 249, Houston, TX 77025-3018 | 2020-05-07 |
| 1396381398 | Sixth Dental Partner Pllc | Dentist | 6700 Stonebrook Pkwy Ste 101, Frisco, TX 75034-9639 | 2019-11-25 |
| 1902442155 | Amin Ehsan | Dentist | 106 W Gray St, Houston, Houston, TX 77019 | 2019-11-22 |
| 1629627716 | Mohammad Mehdi Imani Emadi | Dentist | 11970 N Central Expy # 430, Dallas, TX 75243 | 2019-09-10 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
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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.