Kelly E Palchik, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

RES10 Issued in ME

Practice address

1048 Union St
Bangor, ME 04401-8600

Phone

(207) 992-2152

Fax

(207) 992-2154

NPI assigned

Jul 6, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1649567116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044018600",
            "telephone_number": "207-992-2152",
            "fax_number": "207-992-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALCHIK",
        "first_name": "KELLY",
        "middle_name": "E",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "RES10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Packard, ATC
• Katricia Rose Padula, MSW, LMSW-CC
• Sherry Sue Page, M.D.
• Irina V Pagula, CRNA
• Vasavi Paidpally, M.D.
• Shelley Lynn Palmer-Burgess, LCSW
• Rachael Palmer, LCSW
• Nathan Charles Paluso, DO
• Michael S Pancoe, M.D.
• Sanjay P Pandey, M.D.

• Dentist in Bangor, ME
• Providers in Bangor, ME by specialty
• Dentist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.