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

Dr. Matthew Ticich, DMD

Individual provider Endodontics · NPI 1407297484

Dr. Matthew Ticich, DMD is an Endodontics in Fort Campbell, Kentucky. Practices as a sole proprietor. Licensed in California, Colorado, Tennessee and Texas.

Licensed in
CA, CO, TN, TX
In the registry since
2013
Specialties on file
4
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

6145 Desert Storm Ave
Fort Campbell, KY 42223-5558
Phone: (951) 529-2070
Show map & directions

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

Specialties & licences

Endodontics (primary) Taxonomy 1223E0200X · Licence 62475 (CA)
Endodontics Taxonomy 1223E0200X · Licence 11869 (TN)
Dentist Taxonomy 122300000X · Licence DEN.00203425 (CO)
General Practice Dentistry Taxonomy 1223G0001X · Licence 31790 (TX)

Record details

NPI number1407297484
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedJuly 8, 2013
Last updated in NPPESJuly 8, 2026
Certification dateJuly 8, 2026