Active NPI
Stephanie R Buxton, LD
- Denturist
- Bangor, ME
National Provider Identifier
1396970802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- 5511
- Practice address
- 12 Stillwater Ave
Bangor, ME 04401-3984 - Phone
- (207) 941-6550
- NPI assigned
- May 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | 5511 | ME | Primary |
Addresses
Primary practice location
12 Stillwater Ave
Bangor, ME 04401-3984
Mailing address
12 Stillwater Ave
Bangor, ME 04401-3984
Phone (207) 941-6550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 433129699 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5511 | ME | MD | Denturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243468800000",
"number": "1396970802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 STILLWATER AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013984",
"telephone_number": "207-941-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 STILLWATER AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013984",
"telephone_number": "207-941-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUXTON",
"first_name": "STEPHANIE",
"middle_name": "R",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-28",
"last_updated": "2009-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "ME",
"license": "5511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "433129699",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.