NPIMap

Organization Active NPI

Maine Tiny Dental LLC

  • Dental Hygienist
  • New Sharon, ME
National Provider Identifier
1124877147
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
Legal business name
MAINE TINY DENTAL LLC
Practice address
303 Kimball Pond Rd
New Sharon, ME 04955-3703
Phone
(207) 500-1525
NPI assigned
May 13, 2024
Last updated
May 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Kelli Desouza, IPDH,RDH,CDANPI 1790544914
Title
Independent Dental Hygienist
Phone
(207) 500-1525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X Primary

Addresses

Primary practice location

303 Kimball Pond Rd
New Sharon, ME 04955-3703

Mailing address

303 Kimball Pond Rd
New Sharon, ME 04955-3703
Phone (207) 500-1525

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1124877147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 KIMBALL POND RD",
            "city": "NEW SHARON",
            "state": "ME",
            "postal_code": "049553703",
            "telephone_number": "207-500-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 KIMBALL POND RD",
            "city": "NEW SHARON",
            "state": "ME",
            "postal_code": "049553703",
            "telephone_number": "207-500-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE TINY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "DESOUZA",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "INDEPENDENT DENTAL HYGIENIST",
        "authorized_official_telephone_number": "207-500-1525",
        "authorized_official_credential": "IPDH,RDH,CDA"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Sharon, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.