MEDICARE: DR. MATTHEW ZHANG DDS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	390200000X	Student in an Organized Health Care Education/Training Program	37592	TX

General Provider Information

NPI Number	:	1205401957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW ZHANG DDS

Provider Business Mailing Address
First Line	:	1430 JOHN WESLEY GILBERT DRIVE
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30912-0001
Country	:	US
Telephone Number	:	706-721-9744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 15TH ST
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30912-3923
Country	:	US
Telephone Number	:	706-721-9744
Fax Number	:

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

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	03/03/2023

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