Katahdin Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KATAHDIN FAMILY DENTAL LLC

Practice address

254 South St
Calais, ME 04619-1322

Phone

(207) 454-2350

Fax

(207) 454-2879

NPI assigned

Sep 17, 2018

Last updated

Sep 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lea Farrar

Title

Office Manager

Phone

(207) 454-2350

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Karen Jo Delaney, DDS

  • Dentist
  • Calais, ME
  • NPI 1104205772
  NPD (past)

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1407330467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 SOUTH ST",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191322",
            "telephone_number": "207-454-2350",
            "fax_number": "207-454-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 SOUTH ST",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191322",
            "telephone_number": "207-454-2350",
            "fax_number": "207-454-2879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Spruce Street East Millinocket",
            "address_purpose": "LOCATION",
            "city": "Calais",
            "state": "ME",
            "postal_code": "046190461",
            "country_code": "US",
            "telephone_number": "207-454-2350",
            "fax_number": "207-454-2879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KATAHDIN FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "FARRAR",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "207-454-2350"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DEN4422",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mae Incannella, FNP
• Ruth Jahn
• John Tkach MD
• Patricia Jollotta, LCPC
• Karen J Delaney DDS
• Katharine Evans, LCSW
• Jennifer N Kehrer, OD
• Candace Jean Kelley, PT
• Katherine B Kincer, CRNA
• Ryan Kizitaff, ADC-A

• Dental Clinic/Center in Calais, ME
• Providers in Calais, ME by specialty
• Dental Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.