Mark a. Mastellotto

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MARK A. MASTELLOTTO

Doing business as

Mark Mastellotto DDS PC

Practice address

760 Riverside Ave
Adrian, MI 49221-1445

Phone

(517) 263-0338

Fax

(517) 263-1138

NPI assigned

Nov 7, 2022

Last updated

Nov 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Arthur Mastellotto, DDSNPI 1013077601

Title

Owner

Phone

(517) 263-0338

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Mark Mastellotto DDS PC Doing business as

Electronic endpoints 7

Tax ID family

Mark a Mastellotto2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mark a Mastellotto Ddspc

  • Dental Laboratory
  • Adrian, MI
  • NPI 1588398333
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark A Mastellotto, DDS

  • Dentist
  • Adrian, MI
  • NPI 1013077601
  NPD Authorized official

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1972211134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211445",
            "telephone_number": "517-263-0338",
            "fax_number": "517-263-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211445",
            "telephone_number": "517-263-0338",
            "fax_number": "517-263-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. MASTELLOTTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "MASTELLOTTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-263-0338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1013077601",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL INSURANCE",
            "identifier": "1013077601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL INSURANCE",
            "identifier": "1013077601",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013077601",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drmarkadrian@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "760 Riverside Ave",
            "city": "Adrian",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492211445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mark Mastellotto DDS PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Marie Mansfield, BS
• Salah Eldein Mansour, PA-C
• Angela Marie Manwaring, PT
• Maple Family Dentistry PLLC
• Mark a Mastellotto Ddspc
• Donna J Markham, PHD
• Stephen Glen Markham, RN
• Kathleen Markovich
• Nathan Vaughan Marks, B.A.
• Donna Marowelli, LLPC

• Clinic/Center in Adrian, MI
• Providers in Adrian, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.