Evan Mast

General Practice Dentistry · Elizabeth, NJ

Individual Active NPI

NPI number 1639707623

Practice location

105 Elmora Ave
Elizabeth, NJ 07202-1614
Phone
(908) 402-0878

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NPI record

NPI
1639707623
Entity type
Individual (Type 1)
Enumeration date
March 27, 2020
Last updated
July 12, 2021
Certified
July 12, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 22DI02819700 NJ
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

302 Foxwood Rd
Union, NJ 07083-7941
Phone
(908) 418-8527

Other practice locations (1)

  • 1 Bay Ave, Montclair, NJ 07042-4837 · (973) 429-6000

About Evan Mast

Evan Mast is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 105 Elmora Ave, Elizabeth, NJ 07202-1614. The NPI number 1639707623 was assigned on March 27, 2020 and the record was last updated on July 12, 2021.

Evan Mast lists a license in the registry: #22DI02819700 (NJ) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Evan Mast?

The NPI number is 1639707623.

What is the phone number of Evan Mast?

The phone number listed for the practice location is (908) 402-0878.

Where is Evan Mast located?

105 Elmora Ave, Elizabeth, NJ 07202-1614.

What is the taxonomy code for Evan Mast?

The primary taxonomy code is 1223G0001X – General Practice Dentistry; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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