Provider Demographics
NPI:1710922810
Name:ROBERT J. MATTHEWS DMD PLLC
Entity Type:Organization
Organization Name:ROBERT J. MATTHEWS DMD PLLC
Other - Org Name:SUN DENTURES AND DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-972-1200
Mailing Address - Street 1:12801 W BELL RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9797
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:623-972-3405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ862880OtherACCCHS