MEDICARE: DR. RANDALL MATUSZEWSKI D.D.S.

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	1223G0001X	General Practice Dentistry	19020149	IL

General Provider Information

NPI Number	:	1205831286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDALL MATUSZEWSKI D.D.S.

Provider Business Mailing Address
First Line	:	210 N PINE ST
Second Line	:
City	:	NEW LENOX
State	:	IL
Zip	:	60451-1757
Country	:	US
Telephone Number	:	815-485-8252
Fax Number	:	815-485-8361

Provider Business Practice Location Address
First Line	:	210 N PINE ST
Second Line	:
City	:	NEW LENOX
State	:	IL
Zip	:	60451-1757
Country	:	US
Telephone Number	:	815-485-8252
Fax Number	:	815-485-8361

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1114858776 — GOGINENI DENTAL
Practice Location Address:

210 N PINE ST
NEW LENOX, IL
60451-1757

Practice Phone: 815-485-8252
Practice Fax:

1184454647 — STATION PHARMACY NY LLC
Practice Location Address:

1757 NEW YORK AVE
HUNTINGTON STATION, NY
11746-2407

Practice Phone: 631-418-8953
Practice Fax: 631-418-8954

1770560344 — NUZHAT H SIDDIQUI DDS
Practice Location Address:

1757 NEW YORK AVE
HUNTINGTON STATION, NY
11746-2407

Practice Phone: 631-385-5650
Practice Fax:

1467488155 — CG-DSA, LLC
Practice Location Address:

1757 S 600 W
NEW PALESTINE, IN
46163-9790

Practice Phone: 317-477-0093
Practice Fax: 317-348-3430

1811003908 — DR. AZIZ KHAN DDS
Practice Location Address:

1757 NEW YORK AVE
HUNTINGTON STATION, NY
11746-2407

Practice Phone: 631-423-6491
Practice Fax:

1568603389 — MRS. STEPHANIE KARIS DOWNEY TOLEDO M.S. CCC- SLP
Practice Location Address:

140 E 40TH ST APT 8F
NEW YORK, NY
10016-1757

Practice Phone: 203-449-9468
Practice Fax:

Directions to “ DR. RANDALL MATUSZEWSKI D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.