Deering Center Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DEERING CENTER DENTAL LLC

Practice address

163 Pleasant Ave Apt 2
Portland, ME 04103-3242

Phone

(207) 771-2093

NPI assigned

Nov 1, 2022

Organization subpart

No

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

Authorized official

Name

Jacob Nichols, DMDNPI 1013533496

Title

Dentist

Phone

(207) 408-1001

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 2

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

• Jacob Nichols, DMD

  • General Practice Dentistry
  • Portland, ME
  • NPI 1013533496
  NPD Authorized official
• Alan Brewster Rich Jr., DMD

  • Dentist
  • Portland, ME
  • NPI 1194905034
  NPD (past)

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1245947092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 PLEASANT AVE APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033242",
            "telephone_number": "207-771-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 PLEASANT AVE APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033242",
            "telephone_number": "207-771-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERING CENTER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "207-408-1001",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.deeringcenterdental.com",
            "affiliation": "N",
            "endpointDescription": "Practice Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "163 Pleasant Ave Apt 2",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041033242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bart Joseph Decristoforo, P.A - C
• Michael A Dedekian, MD
• Kyle Stanley Deden, D.C.
• Kathryn Bailey Deep, PA-C
• Elisabeth W. Deeran, MD
• Audrey Defusco, MD
• Jocelyn Del Muro, LCPC
• Antonio Mirabueno Del Rosario III, MD
• Felix Anthony Del Vecchio, MSW, LCSW, LADC, CCS
• Linda Marie Delabruere, PHYSICAL THERAPY

• General Practice Dentistry in Portland, ME
• Providers in Portland, 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 Nov 1, 2022; 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.