Jetport Denture Center Inc.

Primary specialty

DenturistTaxonomy code 122400000X

Legal business name

JETPORT DENTURE CENTER INC.

Practice address

980 Forest Ave Ste 104
Portland, ME 04103-3357

Phone

(207) 774-7645

Fax

(207) 828-5298

NPI assigned

Oct 6, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Austin Carbone, LD

Title

Owner

Phone

(207) 774-7645

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Ashley Dawn Soucy, LD

  • Denturist
  • Portland, ME
  • NPI 1801560842
  NPD
• Kelly Carbone, LD

  • Denturist
  • Portland, ME
  • NPI 1417287244
  NPD (past)

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1922723543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 FOREST AVE STE 104",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033357",
            "telephone_number": "207-774-7645",
            "fax_number": "207-828-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 FOREST AVE STE 104",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033357",
            "telephone_number": "207-774-7645",
            "fax_number": "207-828-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JETPORT DENTURE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "CARBONE",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-774-7645",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LD"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MAINE DENTURIST LICENSE",
            "identifier": "DTR5001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Kathleen Jennings, MD
• Tiffany S. Jensen-Williams, APRN
• Lindsey Marie Jensen, OTR/L
• James Anthony Jernigan, M.D.
• Cynthia L. Jesseman, NNP
• Jennifer A Jewell, MD
• Pamela Jimenez
• JKB Solutions Inc. (EastCoast Caregivers)
• Jo Psychotherapy LLC
• Jocelyn Delmuro

• Denturist in Portland, ME
• Providers in Portland, ME by specialty
• Denturist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.