Individual provider · Type 1 NPI

Nicole Mathew, DT

Dental Therapist · Minneapolis, MN

NPI number 1073013322 Active

Practice location

636 Broadway St NE
Minneapolis, MN 55413-2164

Call (612) 746-1530 Map

Fax (612) 746-1531

Specialties and licenses

TaxonomyCodeLicense
Dental Therapist Primary 125J00000XDT96 (MN)

Dental Therapist: A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therap…

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About NPI 1073013322

Nicole Mathew, DT's National Provider Identifier is 1073013322, issued on Feb 13, 2018. The primary taxonomy on file is Dental Therapist (125J00000X), and the practice location is in Minneapolis, MN. The record was last updated on Feb 13, 2018.