Jacob Lee Masters, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12011008A Issued in IN

Practice address

191 US Highway 31 S
Ste 1
Greenwood, IN 46142-3582

Phone

(317) 881-2500

NPI assigned

Jun 14, 2007

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

Enrolled in IN

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Masters Family Dentistry LLC

  • Dental Clinic/Center
  • Greenwood, IN
  • NPI 1689878415
  NPD (past) Authorized official

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326242157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 US HIGHWAY 31 S",
            "address_2": "STE 1",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423582",
            "telephone_number": "317-881-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 US HIGHWAY 31 S",
            "address_2": "STE 1",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423582",
            "telephone_number": "317-881-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "JACOB",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011008A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khalil Massey, RBT
• Halle Massingale, RBT
• Ann Massy
• Justin Richard Master, DPT
• Masters Family Dentistry LLC
• Rini Mathew, D.O.
• Rebecca Mae Matis
• Matthew R Walton DDS, LLC
• Alexis Matthews, RBT
• Dakota Matthews, RBT

• Dentist in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.