Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Mathew, DT

Individual provider Dental Therapist · NPI 1073013322

Nicole Mathew, DT is a Dental Therapist in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2018.

Licensed in
MN
In the registry since
2018

Practice location Address checks out

636 Broadway St NE
Minneapolis, MN 55413-2164
Phone: (612) 746-1530
Fax: (612) 746-1531
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Therapist (primary) Taxonomy 125J00000X · Licence DT96 (MN)

Record details

NPI number1073013322
Entity typeIndividual (Type 1)
GenderFemale
Credentials DT
Sole proprietorNo
NPI enumeratedFebruary 13, 2018
Last updated in NPPESFebruary 13, 2018
Mailing address636 Broadway St Ne, Minneapolis, MN 55413-2164

Other providers in Minneapolis