Provider Demographics
NPI:1790146538
Name:MEISTER, MATTHEW ADAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ADAM
Last Name:MEISTER
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 1:170 BLEECKER ST APT 4S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1489
Mailing Address - Country:US
Mailing Address - Phone:646-801-3334
Mailing Address - Fax:646-863-3059
Practice Address - Street 1:30 CENTRAL PARK S RM 6C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1628
Practice Address - Country:US
Practice Address - Phone:646-801-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0594211223X0400X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics