NPIMap

Organization Active NPI

Jeffrey S. Mastroianni, D.M.D., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Glen Carbon, IL
National Provider Identifier
1285094862
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
21002018 Issued in IL
Legal business name
JEFFREY S. MASTROIANNI, D.M.D., M.S.
Doing business as
Mastroianni Orthodontics
Practice address
2220 S State Route 157
Suite 125
Glen Carbon, IL 62034-1724
Phone
(618) 288-0600
Fax
(618) 288-8004
NPI assigned
Feb 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Authorized official

Name
Dr. Jeffrey Mastroianni, D.M.D.NPI 1326147489
Title
Ceo
Phone
(618) 288-0600

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 21002018 IL Primary

Addresses

Primary practice location

2220 S State Route 157
Suite 125
Glen Carbon, IL 62034-1724

Mailing address

2220 S State Route 157
Suite 125
Glen Carbon, IL 62034-1724
Phone (618) 288-0600

Other identifiers 1

IdentifierTypeStateIssuer
21002018.OtherILSPECIALTY

Other names 1

  • Mastroianni Orthodontics Doing business as

National Provider Directory

National Provider Directory

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": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1285094862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 S STATE ROUTE 157",
            "address_2": "SUITE 125",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341724",
            "telephone_number": "618-288-0600",
            "fax_number": "618-288-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 S STATE ROUTE 157",
            "address_2": "SUITE 125",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341724",
            "telephone_number": "618-288-0600",
            "fax_number": "618-288-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY S. MASTROIANNI, D.M.D., M.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "MASTROIANNI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-288-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "21002018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALTY",
            "identifier": "21002018.",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mastroianni Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.