NPIMap

Organization Active NPI

Downeast Center for Restorative Dentistry

  • Dentist
  • Kittery, ME
National Provider Identifier
1568709772
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3815 Issued in ME
Legal business name
DOWNEAST CENTER FOR RESTORATIVE DENTISTRY
Practice address
12 Newmarch St
Kittery, ME 03904-1619
Phone
(207) 439-3390
NPI assigned
Jan 8, 2013
Last updated
Jan 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Authorized official

Name
Dr. Brendan Hallissey, DMDNPI 1003995192
Title
Owner
Phone
(207) 439-3390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3815 ME Primary

Addresses

Primary practice location

12 Newmarch St
Kittery, ME 03904-1619

Mailing address

12 Newmarch St
Kittery, ME 03904-1619
Phone (207) 439-3390

National Provider Directory

National Provider Directory

Locations

12 Newmarch St
Kittery, ME 03904
Phone (207) 305-9141

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1568709772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NEWMARCH ST",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041619",
            "telephone_number": "207-439-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NEWMARCH ST",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041619",
            "telephone_number": "207-439-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNEAST CENTER FOR RESTORATIVE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "HALLISSEY",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-439-3390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "3815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittery, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.