Individual provider Active NPI

Robert C Masi, DDS

  • General Practice Dentistry
  • Saint Clair Shores, MI
National Provider Identifier
1871691881
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15534 Issued in MI
Practice address
25630 Little Mack Ave
Saint Clair Shores, MI 48081-2109
Phone
(586) 285-5758
Fax
(586) 285-5410
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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 15534 MI Primary

Addresses

Primary practice location

25630 Little Mack Ave
Saint Clair Shores, MI 48081-2109

Mailing address

1017 Lake Shore Rd
Grosse Pointe Shores, MI 48236-4104
Phone (313) 410-4509

Other practice location 1

19701 Vernier Rd
Suite 260
Harper Woods, MI 48225-1467
Phone (313) 882-1511

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

LicenseStateTypeSpecialty
15534MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert Masi D.D.S P.C General Practice Current Accepting new patients

Locations

25630 Little Mack Ave
St Clr Shores, MI 48081
Phone (586) 774-1180

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1871691881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 LAKE SHORE RD",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "482364104",
            "telephone_number": "313-410-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25630 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812109",
            "telephone_number": "586-285-5758",
            "fax_number": "586-285-5410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19701 Vernier Rd",
            "address_2": "Suite 260",
            "address_purpose": "LOCATION",
            "city": "Harper Woods",
            "state": "MI",
            "postal_code": "482251467",
            "country_code": "US",
            "telephone_number": "313-882-1511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASI",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.