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Deactivated NPI 1912120619 Deactivated / Inactive NPI Male Practitioner

William D C Mattison

Dentist - General Practice • Brooklyn Center, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, William Mattison has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 11, 2007
NPI Deactivation Date April 03, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

William Mattison was a registered Dentist - General Practice practicing in Brooklyn Center, MN. Throughout an active medical career spanning 17 years, William Mattison provided care at the practice location at 5831 BROOKLYN BLVD until profile deactivation on 2024-04-03.

Practice Location & Contact Primary Location

Practice Address

5831 Brooklyn Blvd

Brooklyn Center, MN 55429

Telephone 7635338669
Fax 7635338716
Associated Practice Facility / Clinic
🏢 Brooklyn Blvd. Dental Facility NPI 1932373032

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Brooklyn Center, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
23 Specialists

Practicing in Brooklyn Center, MN (2262 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MN D5042

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Dr. Logan Connor , DMD

Dentist - General Practice

NPI 1043053796

Doctor of Dental Medicine

Dr. Ryan Lembke , DDS

Dentist - General Practice

NPI 1124869607

Doctor of Dental Surgery

NPI 1184513673

Doctor of Dental Surgery

Dr. William Kotonias , DDS

Dentist - General Practice

NPI 1265655963

Doctor of Dental Surgery

NPI 1609556638

Doctor of Dental Surgery

Dr. Lloyd Weber , DDS

Dentist - General Practice

NPI 1649444563

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 03, 2024

Record deactivated on April 03, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 5831 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429 (Tel: 7635338669)

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Updated Business Mailing Address July 08, 2007

Registered at 5831 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429 (Tel: 7635338669)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WILLIAM MATTISON

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D5042 in MN)

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Initial NPI Registration & Enumeration April 11, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1912120619
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 11, 2007
Last Update: July 08, 2007
Deactivation Date: April 03, 2024

Mailing Address

5831 Brooklyn Blvd

Brooklyn Center, MN 55429

Phone: 7635338669

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.