Provider Demographics
NPI:1619401015
Name:MATTHEW E. WARNOCK, DDS, INC.
Entity Type:Organization
Organization Name:MATTHEW E. WARNOCK, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WARNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-778-8555
Mailing Address - Street 1:16985 MONTEREY ST
Mailing Address - Street 2:STE 300A
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5116
Mailing Address - Country:US
Mailing Address - Phone:408-778-8555
Mailing Address - Fax:408-778-8558
Practice Address - Street 1:16985 MONTEREY ST
Practice Address - Street 2:STE 300A
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5116
Practice Address - Country:US
Practice Address - Phone:408-778-8555
Practice Address - Fax:408-778-8558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1008431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty