Active NPI
Nicolette Raquel Mason, DMD, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Charlotte, NC
National Provider Identifier
1164995304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 11329
- Practice address
- 9848 Rea Rd Ste D
Charlotte, NC 28277-0460 - Phone
- (980) 999-6388
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 11329 | NC | Primary |
Addresses
Primary practice location
9848 Rea Rd Ste D
Charlotte, NC 28277-0460
Mailing address
9848 Rea Rd Ste D
Charlotte, NC 28277-0460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11329 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754524800000",
"number": "1164995304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9848 REA RD STE D",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282770460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9848 REA RD STE D",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282770460",
"telephone_number": "980-999-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "NICOLETTE",
"middle_name": "RAQUEL",
"name_prefix": "Dr.",
"credential": "DMD, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2025-08-07",
"certification_date": "2025-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NC",
"license": "11329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.