Individual provider Active NPI

Nicole Anne Hasenfus, D.D.S.

  • General Practice Dentistry
  • Augusta, ME
National Provider Identifier
1619380144
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4370 Issued in ME
Practice address
41 Fuller Rd
Augusta, ME 04330-4910
Phone
(207) 446-8579
Fax
(207) 626-5893
NPI assigned
Jun 2, 2014
Last updated
Jun 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4370 ME Primary

Addresses

Primary practice location

41 Fuller Rd
Augusta, ME 04330-4910

Mailing address

41 Fuller Rd
Augusta, ME 04330-4910
Phone (207) 622-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160129002046 ME Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8426351198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4370MEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hasenfus Family Dental, LLC PastSince Jul 24, 2022 Accepting new patients
Robert a Patenaude DDS PA Past Accepting new patients
Timm & Desrosiers DMD General Practice Past Accepting new patients

Organizations & group practices 3

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1619380144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 FULLER RD",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304910",
            "telephone_number": "207-622-1711",
            "fax_number": "207-626-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 FULLER RD",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304910",
            "telephone_number": "207-446-8579",
            "fax_number": "207-626-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASENFUS",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "4370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.