Nickolas Stanley Maskas, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6365 Issued in LA

Practice address

4720 Lake Street
Lake Charles, LA 70605

Phone

(337) 888-4771

Fax

(337) 888-4772

NPI assigned

Jun 27, 2013

Last updated

Dec 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 29, 2022 through Aug 29, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Louisiana Oral & Implant Surgery

  dba Louisiana Oral and Implant Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Lake Charles, LA
  • NPI 1932759271
  NPD Authorized official

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1679913222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 LAKE STREET",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-888-4771",
            "fax_number": "337-888-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 LAKE STREET",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-888-4771",
            "fax_number": "337-888-4772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1395 Center Dr # D7-6",
            "address_2": "Box 100416",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326100416",
            "country_code": "US",
            "telephone_number": "352-273-6750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5656 Nelson Rd Ste C1",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "70605",
            "country_code": "US",
            "telephone_number": "337-888-4771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASKAS",
        "first_name": "NICKOLAS",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "1190",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "6365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Martin
• Lisa Crosby Martin, CRNA
• Meagan Amber Martin, BACHELOR'S
• Richard L Martinez, M.D.
• Margaret Mascoll, LAC, CCGC
• Masse Chiropractic Clinic
• John Clifton Masse, DC
• Mayance Joseph Mathieu Jr., MA., LPC
• Kimberly Anne Mathis, BS
• Matthew 2540 Corporation (Nepenthe House)

• Oral and Maxillofacial Surgery (Dentist) in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.