NPIMap

Organization Active NPI

Dental Arts of Portland

  • Dentist
  • Portland, ME
National Provider Identifier
1922214865
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
ME3595 Issued in ME
Legal business name
DENTAL ARTS OF PORTLAND
Doing business as
Dental Arts Biddeford
Practice address
2401 Congress St
Suite # 2
Portland, ME 04102-1932
Phone
(207) 773-2111
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Dr. Alex A Mazurenko, DMDNPI 1962591461
Title
Owner
Phone
(207) 773-2111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X ME3595 ME Primary

Addresses

Primary practice location

2401 Congress St
Suite # 2
Portland, ME 04102-1932

Mailing address

2401 Congress St Ste 2
Portland, ME 04102-1969
Phone (207) 773-2111

Other names 1

  • Dental Arts Biddeford Doing business as

National Provider Directory

National Provider Directory

Locations

2401 Congress St
Ste 2
Portland, ME 04102
Phone (207) 773-2111

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1922214865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 CONGRESS ST STE 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021969",
            "telephone_number": "207-773-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CONGRESS ST",
            "address_2": "SUITE # 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021932",
            "telephone_number": "207-773-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ARTS OF PORTLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "MAZURENKO",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-773-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ME",
            "license": "ME3595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Arts Biddeford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.