Michael Brian Hersom, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3440 Issued in ME

Practice address

1060 Commercial St
Glen Cove Dental Associates, PA
Rockport, ME 04856-3801

Phone

(207) 594-5500

Fax

(207) 596-6349

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Glen Cove Dental Associates, P.a.

  • General Practice Dentistry
  • Rockport, ME
  • NPI 1376756569
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1952409880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 COMMERCIAL ST",
            "address_2": "GLEN COVE DENTAL ASSOCIATES, PA",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563801",
            "telephone_number": "207-594-5500",
            "fax_number": "207-596-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 COMMERCIAL ST",
            "address_2": "GLEN COVE DENTAL ASSOCIATES, PA",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563801",
            "telephone_number": "207-594-5500",
            "fax_number": "207-596-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSOM",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nir John Harish, MD
• Peter Kent Harman, MD
• Susan E Harris, CNM
• Sarah Hemphill, MD, MPH
• Christine M Herrick, RN
• Philip Wayne Higgins Jr., DMD
• Rotchana Hirshberg, FNP-BC
• Victoria Hoch, MD
• Bruce A. Hoekstra, M.D.
• Magan Hoffman

• General Practice Dentistry in Rockport, ME
• Providers in Rockport, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.