Individual provider Active NPI

Charlyne P Mason-Dozier, D.D.S.

  • Dentist
  • Kansas City, MO
National Provider Identifier
1811901127
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015236 Issued in MO
Practice address
825 Euclid Ave
Kansas City, MO 64124-2323
Phone
(816) 474-4920
Fax
(816) 474-4914
NPI assigned
Jul 29, 2006
Sex
Female
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
Dentist 122300000X 015236 MO Primary

Addresses

Primary practice location

825 Euclid Ave
Kansas City, MO 64124-2323

Mailing address

6424 N Beaman Ave
Kansas City, MO 64151-1900
Phone (816) 474-4920

Other names 1

  • Charlyne P Mason Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20151014001448 MO Practitioner - Oral Surgery 1456264993 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Swope Health Services CurrentSince Sep 13, 2015 Accepting new patients
Swope Health Services CurrentSince Sep 13, 2015 Accepting new patients

Locations

17844 E 23rd St S
Independence, MO 64057
Phone (816) 257-9716

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130
Phone (816) 599-5500

Organizations & group practices 2

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811901127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 N BEAMAN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641511900",
            "telephone_number": "816-474-4920",
            "fax_number": "816-474-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EUCLID AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641242323",
            "telephone_number": "816-474-4920",
            "fax_number": "816-474-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON-DOZIER",
        "first_name": "CHARLYNE",
        "middle_name": "P",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "015236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLYNE",
            "last_name": "MASON",
            "middle_name": "P",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.