Southern Maine Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3767 Issued in ME

Legal business name

SOUTHERN MAINE PEDIATRIC DENTISTRY

Practice address

75 John Roberts Rd
Suit 10B
South Portland, ME 04106-6914

Phone

(207) 773-3111

NPI assigned

Jul 31, 2007

Last updated

Jul 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Whitney Ralston Wignall, DMDNPI 1750415931

Title

Pediatric Dentist

Phone

(207) 773-3111

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Whitney Wignall, DMD

  • Pediatric Dentistry
  • Falmouth, ME
  • NPI 1750415931
  NPD (past) Authorized official
• Brandy Kraus, R.D.H

  • Dental Hygienist
  • South Portland, ME
  • NPI 1790919769
  NPD (past)
• Keelan Monroe, RDH

  • Dental Hygienist
  • South Portland, ME
  • NPI 1891929865
  NPD (past)

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185840000000",
    "number": "1184814568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD",
            "address_2": "SUIT 10B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-773-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD",
            "address_2": "SUIT 10B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-773-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MAINE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2007-07-31",
        "status": "A",
        "authorized_official_last_name": "WIGNALL",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "RALSTON",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "207-773-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ME",
            "license": "3767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soma Massage & Wellness
• Monica Chan Sonner-Perry, LADC
• Sound Advice Audiology
• South Portland Nursing Home, Inc
• Southern Maine Oral and Maxillofacial Surgery PA
• Southern Maine Physical Therapy
• Southern Maine Physical Therapy, PA
• SPG PC (Back On Track Wellness)
• Christen Spicer, AGACNP
• Sarah Spiegel, LCPC-C

• Dental Clinic/Center in South Portland, ME
• Providers in South Portland, ME by specialty
• Dental Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.