Modern Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MODERN FAMILY DENTISTRY

Practice address

1815 SE US Highway 19
Crystal River, FL 34429-9065

Phone

(352) 795-1223

Fax

(352) 453-5547

NPI assigned

May 2, 2023

Organization subpart

No

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

Authorized official

Name

Michael S Masterson, DMDNPI 1629525258

Title

Owner

Phone

(352) 795-1223

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Masterson

  • Dentist
  • Crystal River, FL
  • NPI 1629525258
  NPD Authorized official
• Jensen Nicole Bouton, DMD

  • Dentist
  • Lakewood Ranch, FL
  • NPI 1770005910
  NPD (past)
• Richard C Swanson, DDS

  • Dentist
  • Crystal River, FL
  • NPI 1609904549
  NPD (past)

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1427747880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SE US HIGHWAY 19",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344299065",
            "telephone_number": "352-795-1223",
            "fax_number": "352-453-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 SE US HIGHWAY 19",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344299065",
            "telephone_number": "352-795-1223",
            "fax_number": "352-453-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-795-1223",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emily Robertson Miranda, SLPA, ITDS
• Bogdan Kryzysztof Mlodzik, MD
• Fagunkumar Modi, MD
• Adnan Mohammadbhoy, D.O.
• Edwin A Moore, D.O
• Jamie Lee Moreno, MSCCCSLP
• MRI Associates of Crystal River

• Dentist in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.