Individual provider Active NPI

Stephen H Mason, D.M.D.

  • General Practice Dentistry
  • Bloomfield, CT
National Provider Identifier
1154440071
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4334 Issued in CT
Practice address
3 Northwestern Dr
Bloomfield, CT 06002-3465
Phone
(860) 242-5594
Fax
(860) 286-9430
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4334 CT Primary

Addresses

Primary practice location

3 Northwestern Dr
Bloomfield, CT 06002-3465

Mailing address

3 Northwestern Dr
Bloomfield, CT 06002-3465
Phone (860) 242-5594

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160502001896 CT Order and Referring Only - DentistPractitioner - Dentist 4183923899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lori L. Fritts, MD, LLC PastSince Mar 19, 2004 Accepting new patients
Family Dental Practice of Bloomfield General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154440071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NORTHWESTERN DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023465",
            "telephone_number": "860-242-5594",
            "fax_number": "860-286-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 NORTHWESTERN DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023465",
            "telephone_number": "860-242-5594",
            "fax_number": "860-286-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.