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Contact Information

MATTHEW J NIELSEN, DDS
224 W D.L. INGRAM
BLD. 1408
CANNON AFB, NM88103
 Phone: 575-784-4041
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MATTHEW J NIELSEN · (Male)

NPI # 1356622401
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/02/2011
Last updated 12/08/2025 - About 6 months ago
Sole proprietor 1 No
Identifiers
  • CO License # DEN-10503
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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