Individual provider Active NPI

Chloe Elizabeth Eisenhaur, DMD

  • Dentist
  • Portland, ME
National Provider Identifier
1386222784
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN5125 Issued in ME
Practice address
117 Auburn St
Portland, ME 04103-6003
Phone
(207) 808-9498
NPI assigned
Mar 30, 2021
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401418289 VA
Dentist 122300000X DEN5125 ME Primary

Addresses

Primary practice location

117 Auburn St
Portland, ME 04103-6003

Mailing address

75 Lee Hwy
Verona, VA 24482-2505
Phone (540) 248-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210629001521 VA Order and Referring Only - DentistPractitioner - Dentist 3971904806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN5125MEMDDentist
0401418289VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1386222784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LEE HWY",
            "city": "VERONA",
            "state": "VA",
            "postal_code": "244822505",
            "telephone_number": "540-248-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 AUBURN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036003",
            "telephone_number": "207-808-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHAUR",
        "first_name": "CHLOE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418289",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN5125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.