Individual provider Active NPI

Garrett Fillebrown, DMD

  • Dentist
  • Lewiston, ME
National Provider Identifier
1467022194
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN4893 Issued in ME
Practice address
110 Canal St
Lewiston, ME 04240-7710
Phone
(207) 784-2211
NPI assigned
Jun 25, 2021
Last updated
Jun 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN4893 ME Primary

Addresses

Primary practice location

110 Canal St
Lewiston, ME 04240-7710

Mailing address

60 Grover Rd
Waterford, ME 04088-3445

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

LicenseStateTypeSpecialty
DEN4893MEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosemarie Sheline DDS PA CurrentSince Jun 27, 2021 Accepting new patients

Locations

110 Canal St
Lewiston, ME 04240
Phone (207) 784-2211

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": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1467022194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 GROVER RD",
            "city": "WATERFORD",
            "state": "ME",
            "postal_code": "040883445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CANAL ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407710",
            "telephone_number": "207-784-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLEBROWN",
        "first_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN4893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.