Active NPI
Monte Edward Masonbrink, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Columbus, OH
National Provider Identifier
1316030885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 30.021594
- Practice address
- 1161 Bethel Rd Ste 303
Columbus, OH 43220-2773 - Phone
- (614) 457-9337
- Fax
- (614) 705-1867
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 30.021594 | OH | Primary |
Addresses
Primary practice location
1161 Bethel Rd Ste 303
Columbus, OH 43220-2773
Mailing address
1151 Bethel Rd Ste 104
Columbus, OH 43220-2775
Phone (614) 457-9337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.021594 | OH | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626912000000",
"number": "1316030885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 BETHEL RD STE 104",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432202775",
"telephone_number": "614-457-9337",
"fax_number": "614-705-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1161 BETHEL RD STE 303",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432202773",
"telephone_number": "614-457-9337",
"fax_number": "614-705-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASONBRINK",
"first_name": "MONTE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2021-07-22",
"certification_date": "2021-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "OH",
"license": "30.021594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.