Individual provider Active NPI

Irving Fitzroy Mason Jr., D.M.D.

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1578587994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10833 Issued in MD
Practice address
3343 Belair Rd
Baltimore, MD 21213-1202
Phone
(410) 276-1535
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10833 MD Primary

Addresses

Primary practice location

3343 Belair Rd
Baltimore, MD 21213-1202

Mailing address

3343 Belair Rd
Baltimore, MD 21213-1202
Phone (410) 276-1535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20160308000827 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4486950052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10833MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578587994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131202",
            "telephone_number": "410-276-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131202",
            "telephone_number": "410-276-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "IRVING",
        "middle_name": "FITZROY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "10833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.