MICHAEL C MATZKIN (NPI# 1760430250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760430250 |
Entity Type | Individual |
Full Name | MICHAEL C MATZKIN |
Credential | DDS |
Practice Address |
56 Franklin St Waterbury CT 06706-1221 |
Mailing Address |
56 Franklin St 3rd Floor Waterbury CT 06706-1221 |
Practice Telephone | 2037097055 |
Practice Fax Number | 2037097750 |
Mailing Telephone | 2037098873 |
Mailing Fax Number | 2037098689 |
Enumeration Date | 2006-05-05 |
Last Update Date | 2011-10-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
003502 | CT | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 002035020 | 05 |
Street Address |
56 FRANKLIN ST |
City | WATERBURY |
State | CT |
Zip Code | 06706-1221 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114929379 | Scovill Medical Group, PC | Internal Medicine | 56 Franklin St, Waterbury, CT 06706-1221 | 2005-06-01 |
1528676459 | Kate Marie Breiner | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-16 |
1417575192 | Muhammad Tasawar Latif | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-09 |
1013534148 | Syed Mustajab Ahmed | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
1558989681 | Brooj Awan | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
1699398438 | Michelle Lauren Yeung | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-05-27 |
1841810967 | Diana Shapoval | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-18 |
1235768649 | Sean Michael Burgwardt | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
1043849326 | Miguel Angel Bravo Jr. | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
1053948430 | Bhavya Vemuri | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-03-25 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
1962881896 | Daniyal Ahmed Ansari | Internal Medicine | 56 Franklin Street, Saint Mary's Hospital, Waterbury, CT 06706 | 2015-05-26 |
1164809885 | Vanessa N. Goyes Ruiz | Student in an Organized Health Care Education/Training Program | 56 Franklin Street, Waterbury, CT 06706 | 2015-05-01 |
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Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225010036 | Lee W. Mcneish | Dentist | 650 Chase Pkwy, Waterbury, CT 06708-3040 | 2005-11-17 |
1437685674 | Spectra Dental LLC | Dentist | 160 Robbins St, Waterbury, CT 06708-2652 | 2017-05-09 |
1235478686 | R.e. Holdings, LLC | Dentist | 835 Wolcott St, Waterbury, CT 06705-1315 | 2013-02-05 |
1992997050 | Elie M. Ferneini | Dentist | 1389 W Main St, Suite 320, Waterbury, CT 06708-3104 | 2007-08-13 |
1700936580 | Rools Dessieux | Dentist | 133 Scovill St, Suite 209, Waterbury, CT 06706-1253 | 2007-01-12 |
1508951468 | Andrew F. Keene | Dentist | 1389 W Main St, Suite 320, Waterbury, CT 06708-3104 | 2006-10-04 |
1033136825 | Greater Waterbury Oral & Maxillofacial Surgeons LLC | Dentist | 1389 W Main St, Suite 320, Waterbury, CT 06708-3104 | 2006-07-16 |
1538193370 | John Joseph Hillgen Iv | Dentist | 1389 W Main St, Suite 320, Waterbury, CT 06708-3104 | 2006-07-10 |
1770516452 | Edward J Karban | Dentist | 1389 W Main St, Suite 320, Waterbury, CT 06708-3104 | 2006-07-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053951350 | Connecticut Oral Surgery and Implant Center, Pllc | Dentist | 314 Flanders Rd Ste 1b, East Lyme, CT 06333-1727 | 2020-01-14 |
1952898025 | Premier Oral Surgery and Implantology Center LLC | Dentist | 411 Barnum Avenue Cutoff Ste 5, Stratford, CT 06614-5100 | 2018-04-15 |
1629595145 | Gary Fishbein Dmd LLC | Dentist | 281 Hartford Tpke Ste 307, Vernon, CT 06066-4707 | 2017-08-25 |
1912428160 | Gm Surgical Associates LLC | Dentist | 130 New London Tpke Ste 3, Norwich, CT 06360-2624 | 2017-06-28 |
1861920068 | Mofs-ct Oral Facial Surgery LLC | Dentist | 1 Boulder Ave, Old Greenwich, CT 06870-1420 | 2017-06-01 |
1881034262 | Christy Lottinger | Dentist | 263 Farmington Ave # Mc1710, Farmington, CT 06030-1267 | 2013-06-28 |
1558618025 | Priceless Dental Care P.C. | Dentist | 60 Waterbury Rd Ste E, Prospect, CT 06712-1251 | 2012-08-14 |
1477840270 | Imanuel Babayev | Dentist | 148 East Ave Ste 3h1, Norwalk, CT 06851-5721 | 2011-06-30 |
1629364997 | New London Dental Care, LLC | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2011-06-24 |
1952600595 | James M. Lee | Dentist | 366 Munger Lane, Bethlehem, CT 06751-1100 | 2011-03-22 |
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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.