Individual provider Active NPI

Brian Mason, DDS

  • General Practice Dentistry
  • Circleville, OH
National Provider Identifier
1790787240
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30021763 Issued in OH
Practice address
1422 Circleville Plaza Dr
Circleville, OH 43113-2269
Phone
(740) 474-6900
Fax
(740) 474-6911
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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 30021763 OH Primary

Addresses

Primary practice location

1422 Circleville Plaza Dr
Circleville, OH 43113-2269

Mailing address

1422 Circleville Plaza Dr
Circleville, OH 43113-2269
Phone (740) 474-6900

Other practice location 1

2215 E High St
Springfield, OH 45505-1319
Phone (937) 325-8555

Other identifiers 1

IdentifierTypeStateIssuer
2429803MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160314000302 OH Practitioner - Oral Surgery 5193021483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30021763OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
M. Alexandrunas, DMD, B. Mason, DDS, R. Gardner, DD-Dental 3, LLC General Practice CurrentSince Sep 23, 2021 Accepting new patients

Locations

1422 Circleville Plaza Dr
Circleville, OH 43113
Phone (740) 474-6900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1790787240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 CIRCLEVILLE PLAZA DR",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431132269",
            "telephone_number": "740-474-6900",
            "fax_number": "740-474-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 CIRCLEVILLE PLAZA DR",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431132269",
            "telephone_number": "740-474-6900",
            "fax_number": "740-474-6911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 E High St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455051319",
            "country_code": "US",
            "telephone_number": "937-325-8555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30021763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2429803",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

Verify at the official NPI Registry.