Individual provider Active NPI

Rhobor Jason Uviasah, D.M.D.

  • General Practice Dentistry
  • Portland, ME
National Provider Identifier
1356637987
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN4191 Issued in ME
Practice address
1200 Brighton Ave
Portland, ME 04102-1029
Phone
(207) 872-6815
Fax
(207) 872-6888
NPI assigned
Jun 22, 2011
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN4191 ME Primary

Addresses

Primary practice location

1200 Brighton Ave
Portland, ME 04102-1029

Mailing address

96 Skillings St
South Portland, ME 04106-6232
Phone (218) 251-0206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170816004016 ME Order and Referring Only - DentistPractitioner - Dentist 4880966498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Toothsuite, PA, LLC CurrentSince Feb 4, 2024 Accepting new patients
American Dental Associates General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1356637987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 SKILLINGS ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066232",
            "telephone_number": "218-251-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021029",
            "telephone_number": "207-872-6815",
            "fax_number": "207-872-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UVIASAH",
        "first_name": "RHOBOR",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN4191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.