Western Maine Dentistry, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN2983 Issued in ME

Legal business name

WESTERN MAINE DENTISTRY, PA

Practice address

193 Main St
Norway, ME 04268-5645

Phone

(207) 743-2649

Fax

(207) 743-0432

NPI assigned

Oct 13, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Tyler Wood, D.M.D.

Title

Dentist

Phone

(207) 743-2649

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1376878199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 MAIN ST",
            "city": "NORWAY",
            "state": "ME",
            "postal_code": "042685645",
            "telephone_number": "207-743-2649",
            "fax_number": "207-743-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 MAIN ST",
            "city": "NORWAY",
            "state": "ME",
            "postal_code": "042685645",
            "telephone_number": "207-743-2649",
            "fax_number": "207-743-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MAINE DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "207-743-2649",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN2983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118930000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Vyr, LADC
• Walgreen Eastern Co Inc
• Tia Rose Warner, LCSW
• Patricia M Watson, RD,LD,MS,CDE
• Western Maine Community Action
• Western Maine Multi Medical Specialist
• Western Maine Multi Medical Specialist
• Western Maine Multi Medical Specialist
• Western Maine Multi Medical Specialists
• Western Maine Multi-Medical Specialist

• General Practice Dentistry in Norway, ME
• Providers in Norway, 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 Oct 13, 2009; 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.