NPIMap

Organization Active NPI

Ellsworth Bucksport Dental Associates

  • Dentist
  • Ellsworth, ME
National Provider Identifier
1679784482
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3036 Issued in ME
Legal business name
ELLSWORTH BUCKSPORT DENTAL ASSOCIATES
Practice address
325 Main St
Ellsworth, ME 04605-1511
Phone
(207) 667-7117
Fax
(207) 667-4061
NPI assigned
May 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jodi Louise Sawyer
Title
Office Manager
Phone
(207) 667-7117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3036 ME Primary

Addresses

Primary practice location

325 Main St
Ellsworth, ME 04605-1511

Mailing address

325 Main St
Ellsworth, ME 04605-1511
Phone (207) 667-7117

National Provider Directory

National Provider Directory
Tax ID family
Ellsworth Bucksport Dental Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

325 Main St
Ellsworth, ME 04605
Phone (207) 667-7117

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679784482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051511",
            "telephone_number": "207-667-7117",
            "fax_number": "207-667-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051511",
            "telephone_number": "207-667-7117",
            "fax_number": "207-667-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH BUCKSPORT DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "207-667-7117",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "3036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.