Mark William Governo, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN5241 Issued in ME

Practice address

12 Newmarch St
Kittery, ME 03904-1619

Phone

(207) 439-3390

NPI assigned

Nov 2, 2006

Last updated

Nov 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Downeast Center for Restorative Dentistry

  • Dentist
  • Kittery, ME
  • NPI 1568709772
  NPD (past)
• George Petrescu-Boboc DDS PLLC

  • General Practice Dentistry
  • Lebanon, NH
  • NPI 1114235785
  NPD (past)
• Mascoma Dental Associates,PLLC

  • General Practice Dentistry
  • Lebanon, NH
  • NPI 1578622726
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1649359746",
    "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": "603-443-0069"
        },
        {
            "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": [
        {
            "address_1": "12 Newmarch St",
            "address_purpose": "LOCATION",
            "city": "Kittery",
            "state": "ME",
            "postal_code": "039041619",
            "country_code": "US",
            "telephone_number": "207-439-3390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "933 Pleasant St Ste 102-103",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027231000",
            "country_code": "US",
            "telephone_number": "617-336-8596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 Croydon Tpke",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "NH",
            "postal_code": "037815402",
            "country_code": "US",
            "telephone_number": "603-443-9737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOVERNO",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "3123",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN5241",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN18732",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016.0134276",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30300297",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONDORDIA",
            "identifier": "807907",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisa Fraser, PT
• Aaron Gerber
• Alaina Michelle Gerrit, PA-C
• Natalie Getty
• Nicholas Gingras
• Jeffrey Graffam, DMD
• Janet L Gray, PTA
• Mark F. Graziano, MD
• Meghan Grovo
• Brendan Hallissey

• General Practice Dentistry in Kittery, ME
• Providers in Kittery, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.