Creative Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CREATIVE DENTAL LLC

Doing business as

Creative Dental Solutions

Practice address

1407 Broadway
Bangor, ME 04401-2403

Phone

(207) 942-3000

Fax

(207) 992-4054

NPI assigned

May 15, 2024

Organization subpart

No

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

Authorized official

Name

David Lee

Title

Coo

Phone

(732) 207-1689

Specialties & licenses 1

Addresses

Other names 1

• Creative Dental Solutions Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sung Jun Yeon, DMD

  • General Practice Dentistry
  • Bangor, ME
  • NPI 1417605460
  NPD
• James Michael Sevey, DMD

  • General Practice Dentistry
  • Bangor, ME
  • NPI 1558463901
  NPD (past)

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1194574723",
    "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": "1407 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012403",
            "telephone_number": "207-942-3000",
            "fax_number": "207-992-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Dental Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Douglas J Cravens, FNP
• Robert Stuart Cravens, FNP
• Rhashelia Shantini Crawford Floris, M.D.
• Jill Ann Crawford, FNP-C
• Tracy JH Crawford, LMT
• Creative Dental Solutions LLC, P.a.
• Creative Options, LLC
• Creative Options, LLC
• Bonnie Creech, PH.D.
• Wanda J. Creed, BC-HIS

• General Practice Dentistry in Bangor, ME
• Providers in Bangor, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.