Emily Grace Gazitua, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

ME3378 Issued in ME

Practice address

27 Western Ave
Hampden, ME 04444-1422

Phone

(207) 862-2600

Fax

(207) 862-2602

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 28, 2016 through Jan 28, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hampden Family Dentistry, P.a.

  • Dentist
  • Hampden, ME
  • NPI 1730102138
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285657635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 WESTERN AVE",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441422",
            "telephone_number": "207-862-2600",
            "fax_number": "207-862-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 WESTERN AVE",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441422",
            "telephone_number": "207-862-2600",
            "fax_number": "207-862-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZITUA",
        "first_name": "EMILY",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "ME3378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity-Leigh Fournier
• Fraser Clinical Consultation Services
• Wallace J Fraser Jr., LCPC
• Fundamental Foot Care, PLLC
• Ashley Gagnon, PT, DPT
• Gentiva Health Services
• Heather Gilbert
• Daniel Cole Gott, DO
• Alicia Laurell Grant-Singh, FNP
• Amy Grant, M.S. CF-SLP

• All providers in Hampden, ME
• Dentist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.