IndividualActive
Jeremy Matis, DDS
NPI 1053685008 · General Practice Dentistry · Fairchild Afb, WA
Provider details
- NPI number
- 1053685008
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Dental Providers
Student, Health Care
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
92d Medical Group
701 Hospital Loop, Suite 350
Fairchild Afb, WA 99011
Phone: (095) 247-4770
Approximate (ZIP-level) locationGet directions
Mailing address
92d Medical Group
Fairchild Afb, WA 99011
Registry dates
- Enumerated
- 2012-03-07
- Last updated
- 2024-06-25
- Certified
- 2024-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.