NPIMap

Organization Active NPI

Maine Dental Boutique, LLC

  • Dental Hygienist
  • Winthrop, ME
National Provider Identifier
1306337290
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
RDH4109 Issued in ME
Legal business name
MAINE DENTAL BOUTIQUE, LLC
Practice address
16 Commerce PLZ Ste 1a
Winthrop, ME 04364-1562
Phone
(207) 930-0833
NPI assigned
May 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Authorized official

Name
Kimberly FichthornNPI 1811408446
Title
Owner
Phone
(207) 930-0833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X RDH4109 ME Primary

Addresses

Primary practice location

16 Commerce PLZ Ste 1a
Winthrop, ME 04364-1562

Mailing address

16 Commerce PLZ Ste 1a
Winthrop, ME 04364-1562
Phone (207) 930-0833

National Provider Directory

National Provider Directory

Locations

16 Commerce Plz
Ste 1A
Winthrop, ME 04364
Phone (207) 930-0833

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1306337290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 COMMERCE PLZ STE 1A",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043641562",
            "telephone_number": "207-930-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 COMMERCE PLZ STE 1A",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043641562",
            "telephone_number": "207-930-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE DENTAL BOUTIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "FICHTHORN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-930-0833"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "ME",
            "license": "RDH4109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winthrop, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.