Individual provider Active NPI

Neal Edward Surrette, DDS

  • Dentist
  • East Millinocket, ME
National Provider Identifier
1912939372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2768 Issued in ME
Practice address
1 Spruce St
East Millinocket, ME 04430
Phone
(207) 746-9353
Fax
(207) 746-9516
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2768 ME Primary

Addresses

Primary practice location

1 Spruce St
East Millinocket, ME 04430

Mailing address

1 Spruce St
East Millinocket, ME 04430
Phone (207) 746-9353

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
2768MEMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912939372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SPRUCE ST",
            "city": "EAST MILLINOCKET",
            "state": "ME",
            "postal_code": "04430",
            "telephone_number": "207-746-9353",
            "fax_number": "207-746-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SPRUCE ST",
            "city": "EAST MILLINOCKET",
            "state": "ME",
            "postal_code": "04430",
            "telephone_number": "207-746-9353",
            "fax_number": "207-746-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRETTE",
        "first_name": "NEAL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "2768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Millinocket, 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.

Verify at the official NPI Registry.