Misty Masotti-Diakon, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

006077 Issued in CT

Practice address

240 Stafford Ave
Bristol, CT 06010-4682

Phone

(860) 584-7682

NPI assigned

May 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bristol-Burlington Health District

  • Public Health or Welfare Agency
  • Bristol, CT
  • NPI 1790743037

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1831753235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HULL ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060107236",
            "telephone_number": "860-212-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 STAFFORD AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104682",
            "telephone_number": "860-584-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOTTI-DIAKON",
        "first_name": "MISTY",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "006077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenndra Martinez, LCSW
• Alexandra Martone, LCSW
• Cory James Mascalo, RPH
• Roseanne Mascolo, LADC
• Susan Mason, LPC LADC
• Melissa Marie Masse, APRN
• Jennifer B Mastrocola, MD
• Brenda Matta
• Marisa Alexandra Matthews
• Suzanne Matulis

• Dental Hygienist in Bristol, CT
• Providers in Bristol, CT by specialty
• Dental Hygienist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.