Maine Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAINE PEDIATRIC DENTISTRY LLC

Practice address

85 Western Ave
South Portland, ME 04106-2423

Phone

(207) 408-0479

NPI assigned

Mar 26, 2024

Last updated

Mar 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David LeeNPI 1770189672

Title

Coo

Phone

(732) 207-1689

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• David Lee, R.PH

  • Pharmacist
  • Springfield, NJ
  • NPI 1770189672
  Authorized official Same address or phone

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1073363677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BRIDGTON RD STE 2",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923754",
            "telephone_number": "732-207-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WESTERN AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062423",
            "telephone_number": "207-408-0479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Great Falls Plz",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "ME",
            "postal_code": "042128103",
            "country_code": "US",
            "telephone_number": "207-784-4222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAINE PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-207-1689"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maine Homecare, LLC (Maine HomeCare)
• Maine Integrative Family Care (Maine Integrative Healthcare)
• Maine Medical Partners (Maine Medical Partners Urology)
• Maine Mobile Diagnostics Inc
• Maine Osteopathic Medicine, LLC
• Maine Recovery Collective, LLC
• Maine Strong Physical Therapy PA
• Mainehealth
• Mainehealth (Maine Medical Partners Urology)
• Maisha Group LLC

• Pediatric Dentistry in South Portland, ME
• Providers in South Portland, ME by specialty
• Pediatric Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.