Shanna Leigh Gagnon, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

3738 Issued in ME

Practice address

14 Merrill St
Farmingdale, ME 04344-1622

Phone

(207) 626-3091

Fax

(207) 622-5499

NPI assigned

Jul 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

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.

• Donald J. Gagnon DMD PA

  • Dentist
  • Farmingdale, ME
  • NPI 1740415363
  NPD (past)
• Gagnon Dental

  • General Practice Dentistry
  • Farmingdale, ME
  • NPI 1023549615
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700810389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 STONEHAM DR.",
            "city": "W. GARDINER",
            "state": "ME",
            "postal_code": "043457515",
            "telephone_number": "207-582-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MERRILL ST",
            "city": "FARMINGDALE",
            "state": "ME",
            "postal_code": "043441622",
            "telephone_number": "207-626-3091",
            "fax_number": "207-622-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "SHANNA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "3738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssah Dennett, DPT
• DLTC Healthcare LLC (Halldale Manor)
• Donald J. Gagnon DMD PA
• Gagnon Dental
• Donald Joseph Gagnon, D.M.D.
• Jill Annette Galen, OTR/L
• Ida M. Gammon-Wilson, LMT, CBT
• Get Up and Grow Therapy, LLC
• Katherine Gonneville
• Ann Griffin Carey

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.