Teledentalassistance

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

TELEDENTALASSISTANCE

Practice address

6 Carriage Way
Scarborough, ME 04074-9602

Phone

(207) 432-0649

NPI assigned

Jun 27, 2022

Organization subpart

No

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

Authorized official

Name

Stacy Caron

Title

Founder

Phone

(207) 432-0649

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1710619010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CARRIAGE WAY",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749602",
            "telephone_number": "207-432-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CARRIAGE WAY",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749602",
            "telephone_number": "207-432-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELEDENTALASSISTANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "CARON",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "207-432-0649"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DL",
            "identifier": "3394298",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DL",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6 Carriage Way",
            "city": "Scarborough",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040749602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie E Taricska, PA-C
• Hector M Tarraza, MD
• Jane Taylor
• Kelsey Taylor
• John Michael Tedesco, MD
• Edward J Teufel, M.D.
• Todd Thauer
• The Shooting Stars Program
• Sean Thomas, MSW, CADC
• Susan Stokes Thompson Brown, MPT

• Public Health Dentistry in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Public Health Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.