Active NPI
Andrew Vincent Mastronardi, DMD
- Dentist
- Port Jefferson Station, NY
National Provider Identifier
1851363014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 043605
- Practice address
- 367 Old Town Rd
Port Jefferson Station, NY 11776-2256 - Phone
- (631) 473-8292
- Fax
- (631) 473-3896
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 043605 | NY | Primary |
Addresses
Primary practice location
367 Old Town Rd
Port Jefferson Station, NY 11776-2256
Mailing address
367 Old Town Rd
Port Jefferson Station, NY 11776-2256
Phone (631) 473-8292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043605 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1851363014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 OLD TOWN RD",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117762256",
"telephone_number": "631-473-8292",
"fax_number": "631-473-3896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "367 OLD TOWN RD",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117762256",
"telephone_number": "631-473-8292",
"fax_number": "631-473-3896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTRONARDI",
"first_name": "ANDREW",
"middle_name": "VINCENT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "043605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
- Brandon Theodore Maslosky, L.P.N.
- Jade Maslosky, REGISTERED NURSE
- Felicity Joy Masone
- Gabrielle Luisa Massucci, MS CF-SLP TSSLD
- Kristyn Leigh Mastridge
- Paul Mastrorocco, DISPENSING OPTICIAN
- Kenneth Ryan Mataragas, PA-C
- Mather Faculty Medical Affiliates, University Faculty Practice Corp
- Karen Matragrano, NP-C
- Kelly A. Matthews, LPN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.