Individual provider Active NPI

David Richard Kerr, D.D.S.

  • General Practice Dentistry
  • Portland, ME
National Provider Identifier
1205858644
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2946 Issued in ME
Practice address
1601 Congress St
Portland, ME 04102-2102
Phone
(207) 775-0001
Fax
(207) 772-5621
NPI assigned
Jul 24, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2946 ME Primary

Addresses

Primary practice location

1601 Congress St
Portland, ME 04102-2102

Mailing address

1601 Congress St
Portland, ME 04102-2102
Phone (207) 775-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016000301 ME Order and Referring Only - DentistPractitioner - Dentist 4385952936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2946MEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David R Kerr CurrentSince Mar 23, 2016 Accepting new patients

Locations

1601 Congress St
Portland, ME 04102
Phone (207) 661-0100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205858644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022102",
            "telephone_number": "207-775-0001",
            "fax_number": "207-772-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022102",
            "telephone_number": "207-775-0001",
            "fax_number": "207-772-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "DAVID",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "2946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.