Individual provider Active NPI

Christine M Mason, D.D.S.

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1649384058
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018112 Issued in MI
Practice address
2565 Forest Hill Ave SE
Ste #200
Grand Rapids, MI 49546-7535
Phone
(616) 949-0230
Fax
(616) 949-1125
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

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 2901018112 MI Primary

Addresses

Primary practice location

2565 Forest Hill Ave SE
Ste #200
Grand Rapids, MI 49546-7535

Mailing address

2565 Forest Hill Ave SE
Ste #200
Grand Rapids, MI 49546-7535
Phone (616) 949-0230

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160328001080 MI Order and Referring Only - DentistPractitioner - Dentist 7618925637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901018112MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
St Johns Smiles General Practice Current Accepting new patients
Dental Health Professionals of Michigan, P.C. General Practice PastSince Dec 26, 2021 Accepting new patients
Partners in Dental Care PC General Practice Past Accepting new patients

Organizations & group practices 3

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649384058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 FOREST HILL AVE SE",
            "address_2": "STE #200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467535",
            "telephone_number": "616-949-0230",
            "fax_number": "616-949-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 FOREST HILL AVE SE",
            "address_2": "STE #200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467535",
            "telephone_number": "616-949-0230",
            "fax_number": "616-949-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.