Active NPI
Christopher Allen Cotterill, D.M.D.
- Pediatric Dentistry
- Portland, ME
National Provider Identifier
1124054051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN5092
- Practice address
- 1 College St
Portland, ME 04103-2617 - Phone
- (207) 221-4747
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7968 | KY | |
| Pediatric Dentistry | 1223P0221X | DEN.00203359 | CO | |
| Pediatric Dentistry | 1223P0221X | 9401 | NC | |
| Pediatric Dentistry | 1223P0221X | 754 | KY | |
| Pediatric Dentistry | 1223P0221X | DEN5092 | ME | Primary |
Addresses
Primary practice location
1 College St
Portland, ME 04103-2617
Mailing address
1 College St
Portland, ME 04103-2617
Phone (207) 221-4784
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60003530 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7968 | KY | MD | Dentist |
| DEN.00203359 | CO | MD | Pediatric Dentist |
| 754 | KY | MD | Pediatric Dentist |
| DEN5092 | ME | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical University of South Carolina | Past | Accepting new patients | |
| University of New England | Dentist | Past | Accepting new patients |
Interoperability endpoints
- ccotterill537949@direct.musc.edu
Organizations & group practices 2
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.
-
- Dentist
- Portland, ME
- NPI 1881937076
-
dba MUSC Pathology Outreach Services
- Clinical Medical Laboratory
- Charleston, SC
- NPI 1437636057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1124054051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 COLLEGE ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032617",
"telephone_number": "207-221-4784",
"fax_number": "207-523-1915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLLEGE ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032617",
"telephone_number": "207-221-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTERILL",
"first_name": "CHRISTOPHER",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "7968",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN.00203359",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "9401",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "KY",
"license": "754",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "ME",
"license": "DEN5092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60003530",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.