NPIMap

Organization Active NPI

Mason Family Dentistry, P.C.

  • Dental Clinic/Center
  • Mason, MI
National Provider Identifier
1124130554
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
17763 Issued in MI
Legal business name
MASON FAMILY DENTISTRY, P.C.
Practice address
624 S Cedar St
Suite 100
Mason, MI 48854-1589
Phone
(517) 676-3770
Fax
(517) 676-3771
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Lance Peters, D.D.SNPI 1619171352
Title
President
Phone
(517) 676-3770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 17763 MI Primary

Addresses

Primary practice location

624 S Cedar St
Suite 100
Mason, MI 48854-1589

Mailing address

624 S Cedar St
Suite 100
Mason, MI 48854-1589
Phone (517) 676-3770

Other names 1

  • James L. Peters, DDS, Family Dentistry Former legal business name

National Provider Directory

National Provider Directory

Locations

624 S Cedar St
Ste 100
Mason, MI 48854
Phone (517) 676-3770

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124130554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S CEDAR ST",
            "address_2": "SUITE 100",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541589",
            "telephone_number": "517-676-3770",
            "fax_number": "517-676-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S CEDAR ST",
            "address_2": "SUITE 100",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541589",
            "telephone_number": "517-676-3770",
            "fax_number": "517-676-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LANCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-676-3770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "17763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James L. Peters, DDS, Family Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mason, MI

Sources for this page

  • 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.