Provider Demographics
NPI:1013021013
Name:MATCHETT, LINDA (DDS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MATCHETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 JOAQUIN DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:916 W BURBANK BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1400
Practice Address - Country:US
Practice Address - Phone:818-567-0522
Practice Address - Fax:818-567-0524
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA378711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice