Individual provider Active NPI

John S Largey, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Bangor, ME
National Provider Identifier
1922333202
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3522 Issued in ME
Practice address
885 Union St Ste 225
Bangor, ME 04401-3074
Phone
(207) 942-6620
Fax
(207) 942-6264
NPI assigned
Oct 5, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3522 ME Primary

Addresses

Primary practice location

885 Union St Ste 225
Bangor, ME 04401-3074

Mailing address

885 Union St Ste 225
Bangor, ME 04401-3074
Phone (207) 942-6620

Other identifiers 2

IdentifierTypeStateIssuer
1275642456OtherMENPI
133160000MedicaidME

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3522MEMDOral and Maxillofacial Surgery (Dentist)
3522MAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1922333202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 UNION ST STE 225",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013074",
            "telephone_number": "207-942-6620",
            "fax_number": "207-943-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 UNION ST STE 225",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013074",
            "telephone_number": "207-942-6620",
            "fax_number": "207-942-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGEY",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "3522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275642456",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133160000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.