Individual provider Active NPI

Michael Kenneth Stewart Firth, L.D

  • Denturist
  • Sanford, ME
National Provider Identifier
1225285539
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
License
5505 Issued in ME
Practice address
1364 Main St
Suite 13, Box 15
Sanford, ME 04073-3660
Phone
(207) 324-4611
Fax
(207) 324-4628
NPI assigned
Aug 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Denturist 122400000X 5505 ME Primary

Addresses

Primary practice location

1364 Main St
Suite 13, Box 15
Sanford, ME 04073-3660

Mailing address

1364 Main Street
Suite 13, Box 15
Sanford, ME 04073-3660
Phone (207) 324-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5505MEMDDenturist

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1225285539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 MAIN STREET",
            "address_2": "SUITE 13, BOX 15",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040733660",
            "telephone_number": "207-324-4611",
            "fax_number": "207-324-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 MAIN ST",
            "address_2": "SUITE 13, BOX 15",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040733660",
            "telephone_number": "207-324-4611",
            "fax_number": "207-324-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIRTH",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH STEWART",
        "name_prefix": "Mr.",
        "credential": "L.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "ME",
            "license": "5505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.