Provider Demographics
NPI:1932895497
Name:MATAM, JOSHUA MATHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MATHEW
Last Name:MATAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6219 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-0372
Mailing Address - Country:US
Mailing Address - Phone:786-387-7063
Mailing Address - Fax:
Practice Address - Street 1:10820 PENDLETON PIKE STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-2952
Practice Address - Country:US
Practice Address - Phone:317-597-0184
Practice Address - Fax:317-932-5978
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN12014674A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty