Whitley Nicole Anderson, LD, RAD
Individual provider Active NPI Denturist · Standish, ME
NPI 1881348860 · NPPES record last updated Feb 8, 2022
Key facts
- NPI
- 1881348860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Denturist 122400000X
- License
- DTR5541 (ME)
- Practice address
- 7 Gretchen LN
Standish, ME 04084 - Phone
- (207) 642-2310
- NPI assigned
- Feb 8, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DTR5541 | ME | MD | Denturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Standish Denture Center,LLC | Past |
Accepting new patients | |
| Standish Denture Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | DTR5541 | ME | Yes |
Addresses
Primary practice location
7 Gretchen LN
Standish, ME 04084
Mailing address
PO Box 549
Standish, ME 04084-0549
Phone (208) 642-2310
Other names
- Mrs. Whitley Nicole Gagnon
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | standishdenturecenter.com | Direct |
Other providers in Standish, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.