MEDICARE: DR. MATT GEBHARDT D.D.S, MS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	D9060	OR

General Provider Information

NPI Number	:	1043470479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATT GEBHARDT D.D.S, MS, PC

Provider Business Mailing Address
First Line	:	3537 CHERRY LN
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-9228
Country	:	US
Telephone Number	:	541-776-7640
Fax Number	:	541-776-7630

Provider Business Practice Location Address
First Line	:	831 ALDER CREEK DR
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-8900
Country	:	US
Telephone Number	:	541-776-7640
Fax Number	:	541-776-7640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	02/15/2026

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