Mason Kasmikha, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601725 Issued in MI

Practice address

19189 W 10 Mile Rd
Southfield, MI 48075-2442

Phone

(248) 996-8756

NPI assigned

May 22, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Professional Denal Alliance of Michigan,LLC

  • Dentist
  • Southfield, MI
  • NPI 1780186080
  NPD (past)

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1457043382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30890 W 10 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362606",
            "telephone_number": "248-890-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19189 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752442",
            "telephone_number": "248-996-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASMIKHA",
        "first_name": "MASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Paul Karris, MD
• Diquita Karva, RN
• Jennie Kasbohm
• Avin John Kashat, PT
• Laura Kaska, PA-C
• Kasmire Pham Management & Consulting
• Katherine M Johnson
• Kathy Chen PSYD PLLC
• Kathy Klein Carney M.D., P.C.
• Kathy'S Maternal Infant Health Program

• General Practice Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.