Matthew Forrest Powell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN4910 Issued in ME

Practice address

1036 Brighton Ave Ste a
Portland, ME 04102-1049

Phone

(207) 773-2150

NPI assigned

Aug 13, 2021

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• York County Community Action Corp

  • Federally Qualified Health Center (FQHC)
  • Springvale, ME
  • NPI 1497923916
  Medicare reassignment NPD ME
• Jet Dental of Maine, PLLC

  • General Practice Dentistry
  • South Portland, ME
  • NPI 1356216949
  NPD General Practice
• Jet Dental of New Hampshire PLLC

  • General Practice Dentistry
  • Amherst, NH
  • NPI 1588539167
  NPD General Practice
• Griffee Dental PC

  • General Practice Dentistry
  • Portland, ME
  • NPI 1922243849
  NPD (past) General Practice
• Juno Dental LLC

  • General Practice Dentistry
  • Portland, ME
  • NPI 1134632813
  NPD (past) General Practice

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 1, 2021.

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1649945494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 BRIGHTON AVE STE A",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021049",
            "telephone_number": "207-773-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 BRIGHTON AVE STE A",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021049",
            "telephone_number": "207-773-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MATTHEW",
        "middle_name": "FORREST",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN4910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "04671",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick K Poulin Jr., MD
• Samuel Poulin, MD
• Amanda Powell, CLC
• Erin J Powell, LCSW
• Kristen Amy Powell, LCSW
• Miranda Powell
• Shannon K Powell, LCSW
• Cassandra Powers, NP
• Riley D Powers, DDS
• Spencer Jacob Powers, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.