Individual provider Active NPI

Anthony Gabriel Massaro, DMD

  • Dentist
  • Fort Stewart, GA
National Provider Identifier
1407429004
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26095 Issued in FL
Practice address
343 Warrior Rd
Fort Stewart, GA 31314
Phone
(578) 020-4333
NPI assigned
Jul 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X DN26095 FL
Dentist 122300000X DN26095 FL Primary

Addresses

Primary practice location

343 Warrior Rd
Fort Stewart, GA 31314

Mailing address

247 Bircholt GRV
Pooler, GA 31322-9868
Phone (954) 299-6577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN26095FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1407429004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 BIRCHOLT GRV",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229868",
            "telephone_number": "954-299-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 WARRIOR RD",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "31314",
            "telephone_number": "578-020-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARO",
        "first_name": "ANTHONY",
        "middle_name": "GABRIEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "DN26095",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.