Jeffrey Scott Mastroianni, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021002018 Issued in IL

Practice address

2220 S. State Route 157
Suite 125
Glen Carbon, IL 62034-1728

Phone

(618) 288-0600

Fax

(618) 288-8004

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 21, 2015 through Sep 21, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jeffrey S. Mastroianni D.M.D., M.S., P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Glen Carbon, IL
  • NPI 1528187549
  NPD (past) Authorized official
• Jeffrey S. Mastroianni, D.M.D., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Glen Carbon, IL
  • NPI 1285094862
  NPD (past) Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1326147489",
    "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": "620341728",
            "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": "620341728",
            "telephone_number": "618-288-0600",
            "fax_number": "618-288-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROIANNI",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.