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Deactivated NPI 1114206158 Deactivated / Inactive NPI Male Practitioner

Dr. Matthew T Tomoda , DDS

Dentist • Blacksburg, VA

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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, Dr. Matthew Tomoda has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 09, 2011
NPI Deactivation Date April 12, 2023
Total Practice Duration ~12 Years of Practice (2011 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Matthew Tomoda, DDS was a registered Dentist practicing in Blacksburg, VA. Throughout an active medical career spanning 12 years, Dr. Tomoda provided care at the practice location at 614 S MAIN ST until profile deactivation on 2023-04-12.

Practice Location & Contact Primary Location

Practice Address

614 S Main St

Blacksburg, VA 240605259

Telephone 5402927662
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Blacksburg, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.7 Yrs
Regional Practice Density
12 Specialists

Practicing in Blacksburg, VA (2514 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

CMS Verified: 2023-06-01
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License VA 0401413453

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1053495093

Doctor of Dental Surgery

NPI 1548344591

Doctor of Dental Medicine

Career & Practice History Timeline

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

14 Historical Events
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Updated Practice Location June 01, 2023

Registered at 614 S MAIN ST, BLACKSBURG, VA 240605259 (Tel: 5402927662)

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Updated Business Mailing Address June 01, 2023

Registered at 1013 CANYON RIDGE RD APT 104, BLACKSBURG, VA 240601277 (Tel: 5402927662)

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Provider Name / Credentials Updated June 01, 2023

Recorded as MATTHEW TOMODA, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2023

Student in an Organized Health Care Education/Training Program

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NPI Profile Deactivated April 12, 2023

Record deactivated on April 12, 2023

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Updated Practice Location August 24, 2021

Registered at 614 S MAIN ST, BLACKSBURG, VA 240605259 (Tel: 5402927662)

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Updated Business Mailing Address August 24, 2021

Registered at 1013 CANYON RIDGE RD APT 104, BLACKSBURG, VA 240601277 (Tel: 5402927662)

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 24, 2021

Dentist (License #0401413453 in VA)

NPI Profile Active August 09, 2011

NPI status registered as active in NPPES database

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Updated Practice Location August 09, 2011

Registered at 39 FIELDHAVEN PL, STAUNTON, VA 244018981 (Tel: 5402927662)

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Updated Business Mailing Address August 09, 2011

Registered at 39 FIELDHAVEN PL, STAUNTON, VA 244018981

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Provider Name / Credentials Updated August 09, 2011

Recorded as MATTHEW TOMODA, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 09, 2011

Student in an Organized Health Care Education/Training Program

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Initial NPI Registration & Enumeration August 09, 2011

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: 1114206158
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 09, 2011
Last Update: June 01, 2023
Deactivation Date: April 12, 2023
Sole Proprietor: Yes

Mailing Address

1013 Canyon Ridge Rd Apt 104

Blacksburg, VA 240601277

Phone: 5402927662

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.