Healthcare Provider Details

I. General information

NPI: 1093121592
Provider Name (Legal Business Name): MATTHEW CARITHERS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 NW 57TH ST
GAINESVILLE FL
32605-6419
US

IV. Provider business mailing address

803 S MAIN ST
GREENSBORO GA
30642-1211
US

V. Phone/Fax

Practice location:
  • Phone: 352-332-8199
  • Fax:
Mailing address:
  • Phone: 706-454-5114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32001
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN014819
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: