Provider Demographics
NPI:1952432593
Name:MATHEWS, RICK (DDS)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:MATHEWS
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 1:5324 BUNKER CT
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3431
Mailing Address - Country:US
Mailing Address - Phone:916-600-2291
Mailing Address - Fax:
Practice Address - Street 1:5324 BUNKER CT
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3431
Practice Address - Country:US
Practice Address - Phone:916-600-2291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA321301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice