Active NPI
Isaac Adesola Adegbola, DDS
- General Practice Dentistry
- Ellsworth, ME
National Provider Identifier
1245043496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN5203
- Practice address
- 206 High St Ste D
Ellsworth, ME 04605-1741 - Phone
- (207) 669-4826
- NPI assigned
- Jan 30, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN5203 | ME | Primary |
Addresses
Primary practice location
206 High St Ste D
Ellsworth, ME 04605-1741
Mailing address
549 Brunswick Street
Yarmouth, NS B5A 4N3
CA
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN5203 | ME | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wagner Auguste Dental PLLC | General Practice | Current | Accepting new patients |
| Ghanem Dental PLLC | General Practice | Current | Accepting new patients |
Locations
206 High St
Ste D
Ellsworth, ME 04605
Phone (207) 669-4826
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1245043496",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "549 BRUNSWICK STREET",
"city": "YARMOUTH",
"state": "NS",
"postal_code": "B5A 4N3"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 HIGH ST STE D",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046051741",
"telephone_number": "207-669-4826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEGBOLA",
"first_name": "ISAAC",
"middle_name": "ADESOLA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-30",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ME",
"license": "DEN5203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellsworth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.