DR. MATTHEW THERIAC (NPI# 1831269158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831269158 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW THERIAC |
| Credential | D.D.S. |
| Practice Address |
905 Jackson St Macon MO 63552-2016 |
| Practice Telephone | 6603853623 |
| Practice Fax Number | 6603853526 |
| Mailing Telephone | 6603853623 |
| Mailing Fax Number | 6603853526 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DEO 15187 | MO | Dental Providers |
| Street Address |
905 JACKSON ST |
| City | MACON |
| State | MO |
| Zip Code | 63552-2016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760679401 | Matthew Theriac, D.d.s. LLC | Health Maintenance Organization | 905 Jackson St, Macon, MO 63552-2016 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1477624161 | Charles Edgar Averill Jr. | Occupational Therapist | 704a South Missouri, Macon, MO 63552 | 2006-11-13 |
| 1629035084 | Missouri Cvs Pharmacy, L.L.C. | Pharmacy | 1105 N Rutherford St, Macon, MO 63552 | 2006-04-28 |
| 1659560688 | Iris Ladawn Gaerditz | Speech-Language Pathologist | 702 N Missouri St, Macon, MO 63552 | 2007-10-16 |
| 1841316296 | Paul Vincent Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-03-21 |
| 1891908612 | Mid Missouri Physical Therapy | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-05-08 |
| 1366568735 | Lara Beth Jones | Physical Therapist | 2005 N. Missouri St., Suite D., Macon, MO 63552-0381 | 2007-03-21 |
| 1871619262 | Abby M Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0387 | 2007-03-21 |
| 1457715906 | Kimberly Oroke | Social Worker | 821 Charles St, Columbia, MO 63552-1064 | 2016-04-11 |
| 1679100507 | Macon County Sheltered Workshop | Private Vehicle | 1103 Enterprise Rd, Macon, MO 63552-1305 | 2020-03-23 |
| Find all providers in zip 63552 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891224861 | Joshua Buckner | Dentist | 4562 Forsyth Rd # 1, Macon, GA 31210-0510 | 2017-06-05 |
| 1679029938 | Gamble Dentalsmart, PC | Dentist | 236 Tom Hill Sr. Blvd., Macon, GA 31210-1815 | 2016-08-28 |
| 1295189595 | Providence Dental LLC | Dentist | 225 N Macon St, Macon, GA 31210-6562 | 2016-04-22 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1497001630 | Samer Mufid Othman | Dentist | 4705 Northside Dr, Suite 100, Macon, GA 31210-1698 | 2012-07-25 |
| 1881959518 | Leigh Underwood Bennett | Dentist | 4226 Hartley Bridge Rd Ste 102, Macon, GA 31216 | 2012-07-09 |
| 1285912527 | Steven N Golubow | Dentist | 6443 Zebulon Rd, Suite 3a and B, Macon, GA 31220-7638 | 2011-08-03 |
| 1497981658 | Mitchell Dental Clinic, Inc. | Dentist | 59 Frontage Rd N, Macon, MS 39341-2372 | 2009-06-02 |
| 1740496280 | John N Bowman Ddspc | Dentist | 133 Lamar St, Macon, GA 31204-3007 | 2007-05-14 |
| 1407060452 | Marion Hall Gray | Dentist | 102 W 8th St, Macon, MS 39341-2624 | 2007-05-09 |
| Find all providers in MACON | ||||
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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.