Individual provider Active NPI

Christopher Allen Cotterill, D.M.D.

  • Pediatric Dentistry
  • Portland, ME
National Provider Identifier
1124054051
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN5092 Issued in ME
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

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
60003530MedicaidKY

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

LicenseStateTypeSpecialty
7968KYMDDentist
DEN.00203359COMDPediatric Dentist
754KYMDPediatric Dentist
DEN5092MEMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University of South Carolina Past Accepting new patients
University of New England Dentist PastSince Dec 10, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.