Jodi Eve Mason, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN17658 Issued in FL

Practice address

2008 Riverside Ave
Suite 101
Jacksonville, FL 32204-4443

Phone

(904) 372-3260

Fax

(904) 385-3704

NPI assigned

May 21, 2007

Last updated

Oct 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Jodi Eve Fair Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bean Sprout Inc

  dba Bean Tree Pediatric Dentistry

  • Dental Clinic/Center
  • Jacksonville, FL
  • NPI 1942698204
  NPD Authorized official

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1932317922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 RIVERSIDE AVE",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044443",
            "telephone_number": "904-372-3260",
            "fax_number": "904-385-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 RIVERSIDE AVE",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044443",
            "telephone_number": "904-372-3260",
            "fax_number": "904-385-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "JODI",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17658",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076760300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282514301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "FAIR",
            "middle_name": "EVE",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Marie Mason, DO
• Dinah Lynn Mason, MFTI
• Eric D Mason, PT
• Erica Nicole Mason, R.D.
• Felicia L Mason, NP
• Lindsay Mason, A.R.N.P.
• Merci Leah Mason
• Sharina Mason, RN
• Sherri Mason
• Stephanie Mason, M.D.

• Pediatric Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.