Philip Ralph Mascia, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

009105 Issued in CT

Practice address

360 Federal Rd
Brookfield, CT 06804-2426

Phone

(203) 775-3344

Fax

(203) 775-1328

NPI assigned

May 5, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1053587592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 FEDERAL RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042406",
            "telephone_number": "203-775-3344",
            "fax_number": "203-775-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 FEDERAL RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042426",
            "telephone_number": "203-775-3344",
            "fax_number": "203-775-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCIA",
        "first_name": "PHILIP",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CT",
            "license": "009105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Malkin, LPC
• Laura Mariani
• Joanne M Marino, LPC, NCC, CCMHC
• Marlene a. Chelso, Aprn
• Daurie Devore Marsden, CRNA, APRN, ACNP
• Robert Mascia, M.D.
• Dorothy McCarty, MS, MATS, NCC, LPC
• Jessica C McClintock
• Kathleen McCoy-Goldstein, FNP
• Amy L McGoldrick, LPC

• Endodontics in Brookfield, CT
• Providers in Brookfield, CT by specialty
• Endodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.