Provider Demographics
NPI:1639726243
Name:CIMA, MATIAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATIAS
Middle Name:
Last Name:CIMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 JENIFER ST NW STE 340
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2086
Mailing Address - Country:US
Mailing Address - Phone:202-686-9100
Mailing Address - Fax:202-363-2249
Practice Address - Street 1:4400 JENIFER ST NW STE 340
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2086
Practice Address - Country:US
Practice Address - Phone:202-686-9100
Practice Address - Fax:202-363-2249
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10020321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice