Active NPI
Jonathan Goold Strout, D.D.S.
- General Practice Dentistry
- Freeport, ME
National Provider Identifier
1730307240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2896
- Practice address
- 46 Mallett Dr
Freeport, ME 04032-1313 - Phone
- (207) 865-3934
- Fax
- (207) 865-4590
- NPI assigned
- Apr 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2896 | ME | Primary |
Addresses
Primary practice location
46 Mallett Dr
Freeport, ME 04032-1313
Mailing address
PO Box 276
Brunswick, ME 04011-0276
Phone (207) 729-7788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2896 | ME | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freeport Dental Associates, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Freeport, ME
- NPI 1447478953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730307240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 276",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040110276",
"telephone_number": "207-729-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 MALLETT DR",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040321313",
"telephone_number": "207-865-3934",
"fax_number": "207-865-4590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROUT",
"first_name": "JONATHAN",
"middle_name": "GOOLD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ME",
"license": "2896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, ME
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.