NPIMap

Organization Active NPI

Maine Dental Group, P.C.

  • General Practice Dentistry
  • Augusta, ME
National Provider Identifier
1154794758
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MAINE DENTAL GROUP, P.C.
Practice address
25 Stone St
Augusta, ME 04330-6114
Phone
(207) 622-9210
NPI assigned
Nov 4, 2015
Last updated
Dec 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
David LeeNPI 1770189672
Title
Coo
Phone
(732) 207-1689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Health Maintenance Organization 302R00000X DEN4051 ME

Addresses

Primary practice location

25 Stone St
Augusta, ME 04330-6114

Mailing address

290 Bridgton Rd Ste 2
Westbrook, ME 04092-3754
Phone (732) 207-1689

Other practice location 1

4 Scott Dyer Road
Cape Elizabeth, ME 04107
Phone (207) 799-1414

Other names 1

  • Gentle Family Dentistry Other name

National Provider Directory

National Provider Directory
Tax ID family
Gentle Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25 Stone St
Augusta, ME 04330
Phone (207) 287-3333

4 Scott Dyer Rd
Cape Elizabeth, ME 04107
Phone (207) 799-1414

Practitioners & affiliated clinicians

Practitioners 7

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": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1154794758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BRIDGTON RD STE 2",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923754",
            "telephone_number": "732-207-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306114",
            "telephone_number": "207-622-9210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Scott Dyer Road",
            "address_purpose": "LOCATION",
            "city": "Cape Elizabeth",
            "state": "ME",
            "postal_code": "04107",
            "country_code": "US",
            "telephone_number": "207-799-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAINE DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-207-1689"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "ME",
            "license": "DEN4051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.