Individual provider Active NPI

Zoe Kiklis Christensen, DDS

  • General Practice Dentistry
  • Gorham, ME
National Provider Identifier
1912404708
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4946 Issued in ME
Practice address
77 South St
Gorham, ME 04038-1715
Phone
(207) 222-0522
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104224 CA
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 4946 ME Primary

Addresses

Primary practice location

77 South St
Gorham, ME 04038-1715

Mailing address

77 South St
Gorham, ME 04038-1715
Phone (914) 216-3620

Other practice location 1

7903 Atlantic Ave Ste G
Cudahy, CA 90201
Phone (323) 773-2200

Other practice location 2

715 S 8th St
Minneapolis, MN 55404-1210
Phone (914) 216-3620

Other practice location 3

701 Park Ave
Minneapolis, MN 55415-1623
Phone (914) 216-3620

Other identifiers 1

IdentifierTypeStateIssuer
1912404708MedicaidME

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

LicenseStateTypeSpecialty
104224CAMDCounselor
4946MEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cherag Dinshaw Sarkari DDS a Dental Corporation General Practice PastSince Aug 1, 2019 Accepting new patients
Western Dental Services, Inc. PastSince Aug 1, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1912404708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SOUTH ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381715",
            "telephone_number": "914-216-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SOUTH ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381715",
            "telephone_number": "207-222-0522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7903 Atlantic Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Cudahy",
            "state": "CA",
            "postal_code": "90201",
            "country_code": "US",
            "telephone_number": "323-773-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041210",
            "country_code": "US",
            "telephone_number": "914-216-3620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "914-216-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIKLIS CHRISTENSEN",
        "first_name": "ZOE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104224",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "4946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912404708",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.