NPIMap

Organization Active NPI

J a Mastromatteo DDS PLLC

  • Dental Clinic/Center
  • Lake Orion, MI
National Provider Identifier
1295075034
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
JM008259 Issued in MI
Legal business name
J A MASTROMATTEO DDS PLLC
Practice address
312 S Broadway St
Lake Orion, MI 48362-2794
Phone
(248) 693-1331
Fax
(248) 693-1385
NPI assigned
Feb 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Authorized official

Name
Dr. Joseph Anthony Mastromatteo, DDSNPI 1689726150
Title
President
Phone
(248) 693-1331

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 JM008259 MI Primary

Addresses

Primary practice location

312 S Broadway St
Lake Orion, MI 48362-2794

Mailing address

312 S Broadway St
Lake Orion, MI 48362-2794
Phone (248) 693-1331

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": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381190400000",
    "number": "1295075034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S BROADWAY ST",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483622794",
            "telephone_number": "248-693-1331",
            "fax_number": "248-693-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S BROADWAY ST",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483622794",
            "telephone_number": "248-693-1331",
            "fax_number": "248-693-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J A MASTROMATTEO DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "MASTROMATTEO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-693-1331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "JM008259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.