Active NPI
Suki Rose Ullrich, DMD
- Dentist
- Portland, ME
National Provider Identifier
1144906603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN5178
- Practice address
- 190 Park Ave
Portland, ME 04102-1000 - Phone
- (207) 874-1028
- NPI assigned
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN5178 | ME | Primary |
Addresses
Primary practice location
190 Park Ave
Portland, ME 04102-1000
Mailing address
38 Cypress St
Portland, ME 04103-2007
Phone (401) 741-1462
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN5178 | ME | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1144906603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 CYPRESS ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032007",
"telephone_number": "401-741-1462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 PARK AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041021000",
"telephone_number": "207-874-1028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLRICH",
"first_name": "SUKI",
"middle_name": "ROSE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-27",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ME",
"license": "DEN5178",
"primary": true
}
],
"identifiers": [],
"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 12, 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.