NPIMap

Organization Active NPI

Roosevelt Dental

Doing business as Androscoggin Dental Care

  • Dental Clinic/Center
  • Topsham, ME
National Provider Identifier
1376073254
Registry record updated Jun 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
ME4101 Issued in ME
Legal business name
ROOSEVELT DENTAL
Doing business as
Androscoggin Dental Care
Practice address
7 Main St
Topsham, ME 04086-1216
Phone
(207) 729-3911
NPI assigned
Jun 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2017

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

Authorized official

Name
Eugene Kim
Title
Owner/Dentist
Phone
(207) 729-3911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X ME4101 ME Primary

Addresses

Primary practice location

7 Main St
Topsham, ME 04086-1216

Mailing address

7 Main St
Topsham, ME 04086-1216

Other names 1

  • Androscoggin Dental Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497398400000",
    "number": "1376073254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MAIN ST",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MAIN ST",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861216",
            "telephone_number": "207-729-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "207-729-3911"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ME",
            "license": "ME4101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Androscoggin Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Topsham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.