Active NPI
Holly Marie Shepherd, D.D.S., M.P.H.,FACP
- Dentist
- South Portland, ME
National Provider Identifier
1861828675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4335
- Practice address
- 440 Western Ave
South Portland, ME 04106-1724 - Phone
- (207) 775-6348
- Fax
- (207) 775-6311
- NPI assigned
- Sep 25, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4335 | ME | Primary |
Addresses
Primary practice location
440 Western Ave
South Portland, ME 04106-1724
Mailing address
440 Western Ave
South Portland, ME 04106-1724
Phone (207) 775-6348
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 |
|---|---|---|---|
| 4335 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1861828675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 WESTERN AVE",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061724",
"telephone_number": "207-775-6348",
"fax_number": "207-775-6311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 WESTERN AVE",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061724",
"telephone_number": "207-775-6348",
"fax_number": "207-775-6311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "HOLLY",
"middle_name": "MARIE",
"credential": "D.D.S., M.P.H.,FACP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ME",
"license": "4335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.