MATTHEW J MCCULLOUGH DMD PC NPI 1245379171

NPI Information

  • NPI: 1245379171
  • Provider Name: MATTHEW J MCCULLOUGH DMD PC
  • Classification: Dentist - 122300000X
  • Entity Type: Organization
  • Address: 1300 E CITY ROUTE 40
    GREENVILLE, IL
    ZIP 62246
  • Phone: (618) 664-1483

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NPI Details

MATTHEW J MCCULLOUGH DMD PC is a dentist in Greenville, IL. The provider is 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. MATTHEW J MCCULLOUGH DMD PC NPI is 1245379171. The provider is registered as an organization entity type.

The provider's business location address is:

1300 E CITY ROUTE 40
GREENVILLE, IL
ZIP 62246-501
Phone: (618) 664-1483

The provider's authorized official is Matthew James Mccullough .
The authorized official title is President and has the following contact phone number (618) 664-1483.

The enumeration date for this NPI number is 2/6/2007 and was last updated on 5/7/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332BC3200XDurable Medical Equipment & Medical SuppliesCustomized Equipment019-025298ILLINOISNo
2122300000XDentist019025298ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17316230001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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