Provider Demographics
NPI:1477166718
Name:DRS. MATIA & LEMKE, LLC.
Entity Type:Organization
Organization Name:DRS. MATIA & LEMKE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:IRWIN
Authorized Official - Last Name:MATIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:216-570-8827
Mailing Address - Street 1:1706 BEALL AVE
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2378
Mailing Address - Country:US
Mailing Address - Phone:330-264-5851
Mailing Address - Fax:
Practice Address - Street 1:1706 BEALL AVE
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2378
Practice Address - Country:US
Practice Address - Phone:330-264-5851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1265720767OtherMATTHEW J. LEMKE, DDS, MS
OH1083782387OtherOHIO STATE DENTAL BOARD