Mahaffey, Jasun
Mahaffey, Jasun is an individual health care provider with primary practice located at 388 Park Ave , Worcester MA 01610-1025. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Mahaffey, Jasun can be contacted via phone (508) 798-6565.Contact Information
Primary practice address
388 Park Ave
Worcester MA 01610-1025
Phone: (508) 798-6565
Fax: (508) 798-6687
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DL10614 | Massachusetts |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DN1855938 | Massachusetts |
Profile Details
| NPI number | 1578899829 |
|---|---|
| LBN Legal business name | Mahaffey, Jasun |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2009 |
| Last updated | Feb 5th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578899829 | NPPES |
| Massachusetts | MEDICAID | 110092502A |
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