Daniel Lee Massie, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19-025510 Issued in IL

Practice address

200 N Giant City Rd
Carbondale, IL 62902-6410

Phone

(618) 529-2711

Fax

(618) 351-0393

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 Feb 16, 2015 through Feb 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1376613539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629026410",
            "telephone_number": "618-529-2711",
            "fax_number": "618-351-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629026410",
            "telephone_number": "618-529-2711",
            "fax_number": "618-351-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIE",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-025510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "T.I.N.",
            "identifier": "37-1408733",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin M Martin, DO
• Kurt Martin, M.D.
• Laterriea Martin, LCSW
• Melissa A Martinez Mateo, M.D.
• Benjamin D Mason, MD
• John E Massie, ATC, LAT
• Mary Rita Matteson, COTA/L
• Michael Leroy Matteson, PA C
• Courtney Lyn Maynor, OTR/L
• Chastity K Mays, CD(DONA0

• General Practice Dentistry in Carbondale, IL
• Providers in Carbondale, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.