Individual provider Active NPI

Arthur Norman Medina, DDS, MS, MSPH

  • General Practice Dentistry
  • Camden, ME
National Provider Identifier
1417076902
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
ME3460 Issued in ME
Practice address
100 Elm St
Camden, ME 04843-1934
Phone
(207) 236-4740
NPI assigned
Mar 28, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X ME3460 ME Primary

Addresses

Primary practice location

100 Elm St
Camden, ME 04843-1934

Mailing address

100 Elm St
Camden, ME 04843-1934
Phone (207) 236-4740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20161208000583 ME Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5496035446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ME3460MEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Medina Inc. PA General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417076902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ELM ST",
            "city": "CAMDEN",
            "state": "ME",
            "postal_code": "048431934",
            "telephone_number": "207-236-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELM ST",
            "city": "CAMDEN",
            "state": "ME",
            "postal_code": "048431934",
            "telephone_number": "207-236-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ARTHUR",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, MSPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "ME3460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, ME

Sources for this page

Verify at the official NPI Registry.