DR. WENDY L MATIS (NPI# 1407851595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407851595 |
| Entity Type | Individual |
| Full Name | DR. WENDY L MATIS |
| Credential | M.D. |
| Practice Address |
710 E 200 S Ste 1b Salt Lake City UT 84102-2265 |
| Mailing Address |
Po Box 9697 Salt Lake City UT 84109-9697 |
| Practice Telephone | 8015210100 |
| Mailing Telephone | 8015210100 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2016-01-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 185450-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
710 E 200 S STE 1B |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790016434 | Matis Dermatology, PC | Dermatology | 710 E 200 S, Salt Lake City, UT 84102-2265 | 2010-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548680184 | West Valley Dermatology | Dermatology | 3465 S Pioneer Pkwy, Suite 1, Salt Lake City, UT 84120-2076 | 2014-04-22 |
| 1558782276 | Margaret Maria Cocks | Dermatology | 30 N 1900 E Rm 4a330, Salt Lake City, UT 84132-0002 | 2013-12-23 |
| 1588007520 | Blake Patrick Sampson | Dermatology | University of Utah Department of Dermatology, 30 N 1900 E, Salt Lake City, UT 84132-0001 | 2013-04-09 |
| 1689943219 | Richard H Odell Md PC | Dermatology | 1345 E 3900 S. Suite 110, Salt Lake City, UT 84124 | 2011-12-28 |
| 1770779050 | Keith Duffy | Dermatology | University of Utah Dept Of, 50 N Medical Dr, Salt Lake City, UT 84112-1102 | 2007-09-19 |
| 1255543971 | Norman Everett Bystol | Dermatology | 4021 S 700 East, Suite 300 Comp Health, Salt Lake City, UT 84107 | 2007-05-04 |
| 1740346071 | Rosemary Ann Deshazo | Dermatology | 50 N 1900 E, Univ of Utah Internal Medicine Dept, Som 4c104, Salt Lake City, UT 84132-0001 | 2006-12-29 |
| 1215999875 | Richard H Odell | Dermatology | 1345 E 3900 S Ste 110, Salt Lake City, UT 84124-4403 | 2006-04-06 |
| 1659350049 | Don L Reese | Dermatology | 999 Murray Holladay Rd, Suite 207, Salt Lake City, UT 84117-4901 | 2006-01-13 |
| 1356905046 | Dev Ram Sahni | Dermatology | 30 N 1900 E Rm 4a330, Salt Lake City, UT 84132-0002 | 2019-04-28 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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| 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.