NPIMap

Organization Active NPI

Kennebunk Family Dental Care

Doing business as Kennebunk Center for Dentistry

  • General Practice Dentistry
  • Kennebunk, ME
National Provider Identifier
1013121193
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3156 Issued in ME
Legal business name
KENNEBUNK FAMILY DENTAL CARE
Doing business as
Kennebunk Center for Dentistry
Practice address
2 Livewell Drive
Suite #105
Kennebunk, ME 04043
Phone
(207) 985-7944
Fax
(207) 985-8717
NPI assigned
May 9, 2007
Last updated
Mar 26, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
KENNEBUNK FAMILY DENTAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wesley David Mills, DDS
Title
Owner
Phone
(207) 985-7944

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X ME
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3156 ME Primary

Addresses

Primary practice location

2 Livewell Drive
Suite #105
Kennebunk, ME 04043

Mailing address

2 Livewell Drive
Suite #105
Kennebunk, ME 04043
Phone (207) 985-7944

Other identifiers 1

IdentifierTypeStateIssuer
132160000MedicaidME

Other names 1

  • Kennebunk Center for Dentistry Doing business as

National Provider Directory

National Provider Directory
Part of
Kennebunk Family Dental Care

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1013121193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LIVEWELL DRIVE",
            "address_2": "SUITE #105",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "04043",
            "telephone_number": "207-985-7944",
            "fax_number": "207-985-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LIVEWELL DRIVE",
            "address_2": "SUITE #105",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "04043",
            "telephone_number": "207-985-7944",
            "fax_number": "207-985-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBUNK FAMILY DENTAL CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENNEBUNK FAMILY DENTAL CARE",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-985-7944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132160000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennebunk Center for Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.