MATTHEW KOSTELIC (NPI# 1972097251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972097251 |
| Entity Type | Individual |
| Full Name | MATTHEW KOSTELIC |
| Credential | DMD |
| Practice Address |
2265 Lewisville Clemmons Rd Ste A Clemmons NC 27012-7459 |
| Mailing Address |
3580 Stancliff Rd Clemmons NC 27012-9085 |
| Practice Telephone | 3365771583 |
| Mailing Telephone | 3365771583 |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
11043 | NC | Dental Providers |
| Street Address |
2265 LEWISVILLE CLEMMONS RD STE A |
| City | CLEMMONS |
| State | NC |
| Zip Code | 27012-7459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427697978 | Novant Health Clemmons Outpatient Surgery, LLC | Nurse Anesthetist, Certified Registered | 7210 Village Medical Circel, Ste 235, Clemmons, NC 27012 | 2020-01-02 |
| 1528521887 | Novant Health Clemmons Outpatient Surgery, LLC | Clinic/Center | 7210 Village Medical Circle, Suite # 235, Clemmons, NC 27012 | 2019-04-12 |
| 1710382411 | Forsyth Memorial Hospital, Inc | Internal Medicine | 7114 Villiage Medical Circle, Clemmons, NC 27012 | 2014-10-24 |
| 1548661606 | Novant Medical Group, Inc | Orthopaedic Surgery | 7138 Village Medical Circle, Clemmons, NC 27012 | 2014-09-09 |
| 1912323635 | Lutheran Home - Forsyth County, Inc. | Skilled Nursing Facility | 7449 Fair Oaks Drive, Clemmons, NC 27012 | 2014-03-06 |
| 1487910758 | Kelly Elizabeth Kirkpatrick | Specialist/Technologist | 1735 Lewisville Clemmons Road, West Forsyth High School, Clemmons, NC 27012 | 2012-04-11 |
| 1366613663 | Psimed Pa | Psychiatry & Neurology | 2511-d Neudorf Rd, Clemmons, NC 27012 | 2008-03-14 |
| 1871797688 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 5175 Old Clemmons School Road, Clemmons, NC 27012 | 2007-06-14 |
| 1700970878 | Thomas M Anderson Dds Pa | Clinic/Center | 2245 Lewisville Clemmons Road Suite B, Clemmons, NC 27012 | 2006-10-03 |
| 1902998941 | Steven A Cuccia Dds Pa | Dentist | 2265 Lewisville Clemmons Rd, Suite A, Clemmons, NC 27012 | 2006-09-28 |
| Find all providers in zip 27012 | ||||
| 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 |
|---|---|---|---|---|
| 1386158475 | Riccobene & Associates Xxii, Dds, P.a. | Dentist | 4168 Clemmons Rd, Clemmons, NC 27012-7520 | 2017-11-28 |
| 1538548490 | Peter Pryor Jr. | Dentist | 6201 Towncenter Dr # 103, Clemmons, NC 27012-9383 | 2015-05-26 |
| 1295009967 | Sharon L. Reid, Dds, Pa | Dentist | 100 Stadium Oaks Drive, Suite A, Clemmons, NC 27012-8961 | 2012-02-28 |
| 1437160991 | Paul D. Nifong Jr. Ddspa | Dentist | 3624 Clemmons Road, Clemmons, NC 27012-0325 | 2006-08-10 |
| 1518972934 | Paul Douglas Nifong Jr. | Dentist | 3624 Clemmons Rd., Clemmons, NC 27012-8873 | 2006-07-31 |
| 1124047030 | Sharon Lee Reid | Dentist | 100 Stadium Oaks Dr, Clemmons, NC 27012-8961 | 2006-07-19 |
| 1659303139 | Kingery & Kingery, Dds, Pllc | Dentist | 2554 Lewisville Clemmons Rd, Suite 104, Clemmons, NC 27012-8110 | 2006-07-07 |
| 1366854812 | Amy M Pierce | Dentist | 6201 Towncenter Dr, Suite 301, Clemmons, NC 27012-9383 | 2014-06-02 |
| 1528193752 | William H. Kingery Sr. | Dentist | 2554 Lewisville Clemmons Rd, Clemmons, NC 27012-8110 | 2007-02-21 |
| 1366587891 | Mary Ellen Kingery | Dentist | 2554 Lewisville Clemmons Rd, Clemmons, NC 27012-8110 | 2007-02-21 |
| Find all providers in CLEMMONS | ||||
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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.