MEDICARE: MATTHEW J. MESSINA, D.D.S., INC.

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	261QD0000X	Dental Clinic/Center	18529	OH

General Provider Information

NPI Number	:	1154485878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW J. MESSINA, D.D.S., INC.

Provider Business Mailing Address
First Line	:	20390 LORAIN RD
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3411
Country	:	US
Telephone Number	:	440-895-1627
Fax Number	:	440-895-1635

Provider Business Practice Location Address
First Line	:	20390 LORAIN RD
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3411
Country	:	US
Telephone Number	:	440-895-1627
Fax Number	:	440-895-1635

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MATTHEW JOSEPH MESSINA
Credential	:	D.D.S.
Telephone Number	:	440-895-1627

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	08/22/2020

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