Individual provider Active NPI

Lynann Marie Mastaj, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bryn Mawr, PA
National Provider Identifier
1447590344
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
26368 Issued in PA
Practice address
976 E Railroad Ave
Suite 100
Bryn Mawr, PA 19010-3855
Phone
(610) 525-2277
Fax
(484) 380-2763
NPI assigned
Mar 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 26368 PA Primary

Addresses

Primary practice location

976 E Railroad Ave
Suite 100
Bryn Mawr, PA 19010-3855

Mailing address

976 E Railroad Ave
Suite 100
Bryn Mawr, PA 19010-3855
Phone (610) 525-2277

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
26368PAMDOrthodontics and Dentofacial Orthopedic Dentist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1447590344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 E RAILROAD AVE",
            "address_2": "SUITE 100",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103855",
            "telephone_number": "610-525-2277",
            "fax_number": "484-380-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 E RAILROAD AVE",
            "address_2": "SUITE 100",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103855",
            "telephone_number": "610-525-2277",
            "fax_number": "484-380-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTAJ",
        "first_name": "LYNANN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "26368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.