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General NPI Number Information
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NPI Number | 1538051685
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Entity Type | Individual
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Provider Name | JEREMY MASTEN DMD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 222 RICK FRANCIS ST
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City | EL PASO
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State | TX
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Zip | 79905-2817
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Country | US
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Telephone | 915-215-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 KALAKAUA AVE APT 311
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City | HONOLULU
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State | HI
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Zip | 96826-2434
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Country | US
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Telephone | 202-351-9736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0
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License Number State | HI
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