Healthcare Provider Details

I. General information

NPI: 1932017662
Provider Name (Legal Business Name): DESI MATTHEWS DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5613 DURALEIGH RD STE 121
RALEIGH NC
27612-2694
US

IV. Provider business mailing address

5613 DURALEIGH RD STE 121
RALEIGH NC
27612-2694
US

V. Phone/Fax

Practice location:
  • Phone: 910-635-7614
  • Fax: 910-635-7614
Mailing address:
  • Phone: 910-635-7614
  • Fax: 910-635-7614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DESI MATTHEWS
Title or Position: PROSTHODONTIST
Credential: DDS
Phone: 910-635-7614