Sarah Lennan Masterson, DDS, MSD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

2901019457 Issued in MI

Practice address

4211 Parkway Place Dr SW
Suite 104
Grandville, MI 49418-2695

Phone

(616) 249-3500

Fax

(616) 249-3502

NPI assigned

Dec 26, 2007

Sex

Female

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

Enrolled in MI

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Grand River Endodontics PC

  • Endodontics
  • Grandville, MI
  • NPI 1518360304
  NPD (past) Authorized official

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1467636506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 PARKWAY PLACE DR SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182695",
            "telephone_number": "616-249-3500",
            "fax_number": "616-249-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 PARKWAY PLACE DR SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182695",
            "telephone_number": "616-249-3500",
            "fax_number": "616-249-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "SARAH",
        "middle_name": "LENNAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901019457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467636506",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Markvluwer
• Martin J Faasse DPM, PC
• Rachel Elizabeth Martin, CLMSW
• Soraya Jaylin Martinez
• Emma Ann Martonosi, BEHAVIOR TECHNICIAN
• Joshua Matlack, PSYD
• Erin Taylor Matlosz, PSY.D.
• Angela Lalynn Matthews, LLMSW-CLINICAL
• Lindsay Jane Maul, FNP-BC
• Anita Mbabazi, RBT

• Endodontics in Grandville, MI
• Providers in Grandville, MI by specialty
• Endodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.