Mason Mcgillicuddy, DDS
NPI 1124557699 · Dentist · Grand Rapids, MI
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mason Mcgillicuddy, DDS is a Dentist provider in Grand Rapids, MI (NPI 1124557699).
Provider details
- NPI number
- 1124557699
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- UNKNOWN (MI)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-06-08
- Last updated
- 2017-06-08
Frequently asked questions
- What is Mason Mcgillicuddy's NPI number?
- Mason Mcgillicuddy's National Provider Identifier (NPI) is 1124557699, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mason Mcgillicuddy's specialty?
- Mason Mcgillicuddy is listed in the NPPES registry with a primary specialty of Dentist (Dental Providers).
- Where is Mason Mcgillicuddy located?
- Mason Mcgillicuddy's practice location on file with NPPES is 100 Cherry St Se, Grand Rapids, MI 49503-4526.
- What is Mason Mcgillicuddy's phone number?
- The practice phone number listed in the NPPES registry for Mason Mcgillicuddy is (616) 965-8200.
- Does Mason Mcgillicuddy accept Medicare?
- Mason Mcgillicuddy is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mason Mcgillicuddy's NPI active?
- Yes — Mason Mcgillicuddy's NPI (1124557699) is active in the NPPES registry as of the last update on 2017-06-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.