Provider Demographics
NPI:1437202165
Name:MATTHEWS, ROBERT JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12647 W SMOKEY DR STE 113
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-3799
Mailing Address - Country:US
Mailing Address - Phone:623-972-1200
Mailing Address - Fax:623-972-3405
Practice Address - Street 1:12801 W BELL RD
Practice Address - Street 2:SUITE 15
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9797
Practice Address - Country:US
Practice Address - Phone:623-972-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ862880OtherACCCHS PROVIDER NUMBER