NPIMap

Organization Active NPI

Maine Dental Health Out-Reach, Inc

  • Dental Hygienist
  • Winthrop, ME
National Provider Identifier
1669607644
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
Legal business name
MAINE DENTAL HEALTH OUT-REACH, INC
Practice address
45 Greenwood Ter
Winthrop, ME 04364-1505
Phone
(207) 377-7003
NPI assigned
May 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Ms. Susanne J Lavallee, RDHNPI 1922233816
Title
President/Director
Phone
(207) 377-7003

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
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X Primary

Addresses

Primary practice location

45 Greenwood Ter
Winthrop, ME 04364-1505

Mailing address

PO Box 275
Winthrop, ME 04364-0275
Phone (207) 377-7003

Other identifiers 1

IdentifierTypeStateIssuer
431944500MedicaidME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1669607644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 275",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043640275",
            "telephone_number": "207-377-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GREENWOOD TER",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043641505",
            "telephone_number": "207-377-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE DENTAL HEALTH OUT-REACH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "LAVALLEE",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "207-377-7003",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431944500",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winthrop, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.