Organization Active NPI

Maine Prosthodontics

  • Prosthodontics
  • Portland, ME
National Provider Identifier
1457553182
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
3784 Issued in ME
Legal business name
MAINE PROSTHODONTICS
Practice address
1250 Forest Avenue
Portland, ME 04103
Phone
(207) 773-6177
Fax
(207) 773-6552
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Authorized official

Name
Dr. Frank A Musciano, DDS
Title
Official
Phone
(207) 773-6177

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X 2624 ME
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X 3398 ME
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X 3784 ME Primary

Addresses

Primary practice location

1250 Forest Avenue
Portland, ME 04103

Mailing address

1250 Forest Avenue
Portland, ME 04103
Phone (207) 773-6177

Other identifiers 3

IdentifierTypeStateIssuer
432010199MedicaidME
293730099MedicaidME
431940999MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050715000085 ME Part B Supplier - Clinic/Group Practice 8426084955 Receives reassigned benefits from 2 practitioners
Practice locations: Portland, ME

National Provider Directory

National Provider Directory

Locations

1250 Forest Ave
Ste 305
Portland, ME 04103
Phone (207) 773-6177

276 Canco Rd
Portland, ME 04103
Phone (207) 773-6177

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1457553182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 FOREST AVENUE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-773-6177",
            "fax_number": "207-773-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 FOREST AVENUE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-773-6177",
            "fax_number": "207-773-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE PROSTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "MUSCIANO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICIAL",
        "authorized_official_telephone_number": "207-773-6177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "ME",
            "license": "2624",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "ME",
            "license": "3398",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "ME",
            "license": "3784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432010199",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293730099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431940999",
            "state": "ME"
        }
    ],
    "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 Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.