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Mason McGillicuddy, DDS

NPI 1124557699ActiveIndividual· Dentist· Grand Rapids, MI

Dentist (DDS) in Grand Rapids, Michigan, licensed in MI, with an NPI issued in June 2017. Part D covered 32 prescriptions written in 2024.

Overview

NPI1124557699
StatusActive
Entity typeIndividual
CredentialDDS
Sole proprietorNo
NPI issuedJun 8, 2017
Last updated in NPPESJun 8, 2017

Specialties and licenses

TaxonomyCodeLicenseState
Dentist Primary122300000XUNKNOWNMI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Order and Referring Only - Dentist (MI)

Part D prescriptions in 2024

Prescriptions (claims)32 · 39 30-day fills
Patients20
Total drug cost$157.47

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other dentists in Grand Rapids

All 161 dentists in Grand Rapids · All dentists in Michigan