Provider Demographics
NPI:1750910006
Name:O'NEIL, MATTHEW PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PATRICK
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 FM 1626 STE 190
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6044
Mailing Address - Country:US
Mailing Address - Phone:210-872-5445
Mailing Address - Fax:
Practice Address - Street 1:5401 FM 1626 STE 190
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6044
Practice Address - Country:US
Practice Address - Phone:210-872-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366021223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice