Individual provider Active NPI

Nicholas Patrick Sirois, D.M.D.

  • Dentist
  • Rumford, ME
National Provider Identifier
1104186865
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4242 Issued in ME
Practice address
60 Lowell St
Rumford, ME 04276-2064
Phone
(207) 369-3600
NPI assigned
May 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4242 ME Primary

Addresses

Primary practice location

60 Lowell St
Rumford, ME 04276-2064

Mailing address

10 Brunswick Ter
Gardiner, ME 04345-2429
Phone (207) 798-9268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713002060 ME Order and Referring Only - DentistPractitioner - Dentist 7113230624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4242MEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Dental Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1104186865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRUNSWICK TER",
            "city": "GARDINER",
            "state": "ME",
            "postal_code": "043452429",
            "telephone_number": "207-798-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 LOWELL ST",
            "city": "RUMFORD",
            "state": "ME",
            "postal_code": "042762064",
            "telephone_number": "207-369-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROIS",
        "first_name": "NICHOLAS",
        "middle_name": "PATRICK",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "4242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rumford, ME

Sources for this page

Verify at the official NPI Registry.