Lifetime Dental Health, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2508 Issued in ME

Legal business name

LIFETIME DENTAL HEALTH, PA

Practice address

731 Roosevelt TRL
Windham, ME 04062-5269

Phone

(207) 892-8548

Fax

(207) 892-6651

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Samuel Green, D.M.D.NPI 1861477606

Title

President

Phone

(207) 892-8548

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Robert Samuel Green, DMD

  • General Practice Dentistry
  • Windham, ME
  • NPI 1861477606
  NPD (past) Authorized official
• Timothy R Adamchuk, DMD

  • General Practice Dentistry
  • Windham, ME
  • NPI 1871190926
  NPD (past)
• Melissa Coffey Sears

  • Dentist
  • Portland, ME
  • NPI 1245848118
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750435558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625269",
            "telephone_number": "207-892-8548",
            "fax_number": "207-892-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625269",
            "telephone_number": "207-892-8548",
            "fax_number": "207-892-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL HEALTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-892-8548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "2508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-PERSONAL NUMBER",
            "identifier": "1861477606",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Leblanc, N.P.
• Ledgewood Manor, Inc
• Legends Residential Care LLC
• Deighton Lewis, PA-C
• Jocelyn Liang, LCPC-CC
• Mandy Lee Logsdon, CADC
• Lombard Counseling Services LLC
• Matthew K Lombard, LCSW
• Christopher James Lonegan, DO
• Kathleen Long, PH.D.

• General Practice Dentistry in Windham, ME
• Providers in Windham, ME by specialty
• General Practice Dentistry in Maine

• 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.