Individual provider Active NPI

Madelyn Mascaro, DDS

  • General Practice Dentistry
  • Lakewood Ranch, FL
National Provider Identifier
1356109748
Registry record updated Jun 25, 2025
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN29216 Issued in FL
Practice address
6588 University Pkwy Ste 104
Lakewood Ranch, FL 34240-9296
Phone
(941) 256-3714
NPI assigned
Mar 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN29216 FL Primary

Addresses

Primary practice location

6588 University Pkwy Ste 104
Lakewood Ranch, FL 34240-9296

Mailing address

5360 Desoto Rd Apt 5207
Sarasota, FL 34235-2722
Phone (716) 946-9179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20250916002871 FL Order and Referring Only - DentistPractitioner - Dentist 2062916802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1356109748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 DESOTO RD APT 5207",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342352722",
            "telephone_number": "716-946-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6588 UNIVERSITY PKWY STE 104",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342409296",
            "telephone_number": "941-256-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARO",
        "first_name": "MADELYN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.