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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578899829 NPPES
Massachusetts MEDICAID 110092502A

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