Shilo Annis DMD, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHILO ANNIS DMD, PLLC

Practice address

42 Highland Rd
Bridgton, ME 04009-1237

Phone

(207) 647-3628

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Shilo Annis, DMDNPI 1235668179

Title

Owner/Ceo

Phone

(207) 272-9847

Specialties & licenses 1

Addresses

Other names 1

• Mountain View Dentistry Doing business as

Locations

Practitioners 3

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

• Shilo Annis, DMD

  • Dentist
  • Bridgton, ME
  • NPI 1235668179
  NPD (past) Authorized official
• Leslie Ann Elston, DMD

  • Dentist
  • Bridgton, ME
  • NPI 1851570972
  NPD (past)
• Jude Jocham, DDS

  • Dentist
  • Auburn, ME
  • NPI 1144697335
  NPD (past)

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1508482183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MIDNIGHT LN",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382376",
            "telephone_number": "207-272-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 HIGHLAND RD",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040091237",
            "telephone_number": "207-647-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILO ANNIS DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "ANNIS",
        "authorized_official_first_name": "SHILO",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "207-272-9847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Lee Sadowski-Badeau, LCPC
• Samantha Leduc DMD PLLC
• Grace Anne Sanborn, OTR/L
• Megan Selina Sawyer, BCBA
• Georgia Shanks
• Constance Slater, P.T.
• Shannon Alyssa Kane Slayton, MD
• Jay W Sprinkle, LCSW
• Stephan L. Hatch, DMD
• Kimberly Ann Struck, LCSW

• All providers in Bridgton, ME
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.