NPIMap

Organization Active NPI

Alexandra Y Peacock Cathcart DMD LLC

Doing business as Coastal Family Dental

  • General Practice Dentistry
  • Portland, ME
National Provider Identifier
1154446672
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3047 Issued in ME
Legal business name
ALEXANDRA Y PEACOCK CATHCART DMD LLC
Doing business as
Coastal Family Dental
Practice address
110 Auburn Street
Portland, ME 04103
Phone
(207) 797-7433
Fax
(207) 797-7720
NPI assigned
Mar 21, 2007
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Alexandra Yamva Peacock Cathcart, D.M.D.NPI 1619461282
Title
Owner
Phone
(413) 446-6346

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
General Practice Dentistry 1223G0001X 3047 ME Primary

Addresses

Primary practice location

110 Auburn Street
Portland, ME 04103

Mailing address

110 Auburn Street
Portland, ME 04103
Phone (207) 797-7433

Other identifiers 1

IdentifierTypeStateIssuer
124010000MedicaidME

Other names 1

  • Coastal Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

110 Auburn St
Portland, ME 04103
Phone (207) 797-7433

Practitioners & affiliated clinicians

Practitioners 6

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1154446672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 AUBURN STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-797-7433",
            "fax_number": "207-797-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 AUBURN STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-797-7433",
            "fax_number": "207-797-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRA Y PEACOCK CATHCART DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-06-27",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "PEACOCK CATHCART",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "YAMVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-446-6346",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124010000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 27, 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.