NPIMap

Organization Active NPI

Foreside Family Dental PLLC

  • Dentist
  • Kittery, ME
National Provider Identifier
1376931782
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4412 Issued in ME
Legal business name
FORESIDE FAMILY DENTAL PLLC
Practice address
23 Walker St
Kittery, ME 03904-1728
Phone
(207) 439-2310
NPI assigned
Jan 7, 2015
Last updated
Jan 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Alexis HallisseyNPI 1770894149
Title
Owner
Phone
(302) 354-0155

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
Dentist 122300000X 4412 ME Primary

Addresses

Primary practice location

23 Walker St
Kittery, ME 03904-1728

Mailing address

23 Walker St
Kittery, ME 03904-1728

National Provider Directory

National Provider Directory

Locations

23 Walker St
Kittery, ME 03904
Phone (207) 439-2310

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": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1376931782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WALKER ST",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WALKER ST",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041728",
            "telephone_number": "207-439-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORESIDE FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "HALLISSEY",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-354-0155"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "4412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittery, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.