MR. MATT R AGNEW


Address: 1270 W Main St, Sun Prairie, WI 53590-1930
Phone: 6084435482

MR. MATT R AGNEW (NPI# 1295916419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295916419
Entity Type Individual
Full Name MR. MATT R AGNEW
Credential DMD
Practice Address 1270 W Main St
Sun Prairie
WI 53590-1930
Mailing Address 2901 W. Beltline Hwy.
Suite 120
Madison
WI 53713-4226
Practice Telephone 6084435482
Practice Fax Number 6088379134
Mailing Telephone 6084435500
Mailing Fax Number 6084411981
Enumeration Date 2007-11-15
Last Update Date 2012-04-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223D0001X Dentist
Specialization: Dental Public Health
6179-15 WI Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 33815700 05

Office Location

Street Address 1270 W MAIN ST
City SUN PRAIRIE
State WI
Zip Code 53590-1930

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063995553 Katherine A Schuler Dentist 1270 W Main St, Sun Prairie, WI 53590-1930 2018-09-11
1861849945 Jessica Diaz Dental Hygienist 1270 W Main St, Sun Prairie, WI 53590-1930 2016-05-19
1568823839 Angela Engelmann Dental Hygienist 1270 W Main St, Sun Prairie, WI 53590-1930 2016-03-15
1255772349 Sarah E Dewolf Dentist 1270 W Main St, Sun Prairie, WI 53590-1930 2013-07-17
1205139821 Raymond Matthew Maddox Dentist 1270 W Main St, Sun Prairie, WI 53590-1930 2010-12-21
1417260712 Kasheena S Hollis Dentist 1270 W Main St, Sun Prairie, WI 53590-1930 2010-07-15
1730349432 Jamie L. Mandigo Dentist 1270 W Main St, Sun Prairie, WI 53590-1930 2008-06-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194280529 Kasi Lucas Schroeder Chiropractor 110 N Grand Ave, Suite 4, Sun Prairie, WI 53590 2019-02-11
1770053712 Jamie Engstrom Psychologist 3061 Pleasant St, 216, Sun Prairie, WI 53590 2018-12-03
1154837433 Wisconsin Dental Health, LLC Dentist 390 S. Grand Ave, Suite#110, Sun Prairie, WI 53590 2017-12-21
1669981676 Elizabeth M Gregg Counselor 1170 N Bird St, Sun Prairie, WI 53590 2017-09-21
1609298595 Prairie Lakes Dental Dentist 2804 Prairie Lakes Drive, Sun Prairie, WI 53590 2014-01-10
1407297559 Quality Medical Rides LLC Non-emergency Medical Transport (VAN) 2907 Vang Rd, Sun Prairie, WI 53590 2013-07-17
1376892851 Costco Wholesale Corporation Pharmacy 2850 Hoepker Rd, Sun Prairie, WI 53590 2012-08-30
1043454234 Dean Lewis Drake Registered Nurse 7281 County Rd V. V., Sun Prairie, WI 53590 2009-05-01
1679728992 Dianne Mary Mayr Registered Nurse 3181 Nature Dr, Conservancy States Ln, Sun Prairie, WI 53590 2008-12-01
1043462021 Crown Point Village, LLC Assisted Living Facility 881 Liberty Boulevard, Sun Prairie, WI 53590 2008-10-21
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Taxonomy Information

Taxonomy Code 1223D0001X
Grouping Dental Providers
Classification Dentist
Specialization Dental Public Health

Taxonomy Definition

The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1700390242 Dr. Espinosa Dds Tooth Or Gum, LLC Dentist 784 South Main St, Hartford, WI 53027 2017-11-20
1770777195 James A Brusky Dentist 526 Monroe Ave, Green Bay, WI 54301 2007-08-29
1134343924 James S Kim Dds Sc Dentist 501 S 24th Ave, Ste 200, Wausau, WI 54401-5225 2007-04-12
1104942432 Bruce F Andrekus, Dds,sc Dentist 3726 Roosevelt Rd, Kenosha, WI 53142-1900 2007-03-21
1043293053 Christopher E Okunseri Dentist 1081 W. Wisconsin Ave, Milwaukee, WI 53233-2331 2005-11-22
1780292763 Michelle Kathleen Shipp Dentist 228 S 18th Ave, Sturgeon Bay, WI 54235-1000 2020-07-16
1154813954 Chandler Roemer Dentist 15954 Rivers Edge Dr Ste 304, Hayward, WI 54843-7894 2018-06-06
1962823617 Howard J Lubin Dentist 400 S Townline Rd, Wautoma, WI 54982-6922 2013-12-25
1275971921 Thao Thi-thanh Nguyen Dentist 525 Airport Dr, Oneida, WI 54155-9035 2013-06-04
1215118443 Paula R Duszynski Dentist 3434 E. Washington Ave., Madison, WI 53704-4155 2007-11-15
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Competitor

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City SUN PRAIRIE
Zip Code 53590

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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