Provider Demographics
NPI:1750969556
Name:SILVERMAN, MATTHEW A (DMD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 SIJEN AVE BLDG 2032
Mailing Address - Street 2:
Mailing Address - City:WHITEMAN AFB
Mailing Address - State:MO
Mailing Address - Zip Code:65305-1269
Mailing Address - Country:US
Mailing Address - Phone:660-687-2203
Mailing Address - Fax:
Practice Address - Street 1:331 SIJAN AVENUE
Practice Address - Street 2:BLDG 2032
Practice Address - City:WHITEMAN AFB
Practice Address - State:MO
Practice Address - Zip Code:65305
Practice Address - Country:US
Practice Address - Phone:660-687-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12319756-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist