Active NPI
George Michael Maitre Jr.
- General Practice Dentistry
- Mobile, AL
National Provider Identifier
1457536922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4529
- Practice address
- 801 University Blvd S # a
Mobile, AL 36609-2923 - Phone
- (251) 344-4571
- Fax
- (251) 344-2413
- NPI assigned
- Jan 3, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4529 | AL | Primary |
Addresses
Primary practice location
801 University Blvd S # a
Mobile, AL 36609-2923
Mailing address
801 University Blvd S # a
Mobile, AL 36609-2923
Phone (251) 344-4571
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 510-92383 | Other | AL | BLUE CROSS BLUE SHIELD AL |
| 677496 | Other | UNITED CONCORDIA |
Other names 1
- Dr. G. Michael Maitre Jr.
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 |
|---|---|---|---|
| 4529 | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| G.Michael Maitre DMD 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Mobile, AL
- NPI 1306871405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1457536922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 UNIVERSITY BLVD S # A",
"city": "MOBILE",
"state": "AL",
"postal_code": "366092923",
"telephone_number": "251-344-4571",
"fax_number": "251-344-2413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 UNIVERSITY BLVD S # A",
"city": "MOBILE",
"state": "AL",
"postal_code": "366092923",
"telephone_number": "251-344-4571",
"fax_number": "251-344-2413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAITRE",
"first_name": "GEORGE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-03",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "4529",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD AL",
"identifier": "510-92383",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "677496",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "G.",
"last_name": "MAITRE",
"middle_name": "MICHAEL",
"prefix": "DR.",
"suffix": "JR.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.