Active NPI
Chloe Elizabeth Eisenhaur, DMD
- Dentist
- Portland, ME
National Provider Identifier
1386222784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN5125
- Practice address
- 117 Auburn St
Portland, ME 04103-6003 - Phone
- (207) 808-9498
- NPI assigned
- Mar 30, 2021
- Last updated
- May 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210629001521 | VA | Order and Referring Only - Dentist | 3971904806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN5125 | ME | MD | Dentist |
| 0401418289 | VA | MD | Dentist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.