Mason Dental Group PC

Primary specialty

DentistTaxonomy code 122300000X

License

2901015785 Issued in MI

Legal business name

MASON DENTAL GROUP PC

Practice address

782 E Columbia Street
Mason, MI 48854-1356

Phone

(517) 676-1091

Fax

(517) 676-4954

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Tamara Lynn Bauer Mondragon, DDSNPI 1013119890

Title

President Owner

Phone

(517) 676-1091

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tamara Lynn Bauer-Mondragon, DDS

  • General Practice Dentistry
  • Mason, MI
  • NPI 1013119890
  NPD (past) Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104993484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "782 E COLUMBIA STREET",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541356",
            "telephone_number": "517-676-1091",
            "fax_number": "517-676-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "782 E COLUMBIA STREET",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541356",
            "telephone_number": "517-676-1091",
            "fax_number": "517-676-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAUER MONDRAGON",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "517-676-1091",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Mack, CCC-SLP
• Stacey Manley, RSW
• Marcie Schwartz Mental Health Services LLC
• Halley Marciniak
• Kathleen M Martin, OTRL, CBIS
• Mason Family Dentistry, P.C.
• Mason Family Medicine, PLLC
• Mason Medical Group PC
• Mason Pediatrics
• Matthew Stone LMSW LLC

• Dentist in Mason, MI
• Providers in Mason, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.