LISBON FAMILY DENTAL CARE (NPI# 1083003255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083003255 |
| Entity Type | Organization |
| Organization Name | LISBON FAMILY DENTAL CARE |
| Practice Address |
568 Lisbon St Suite 1 Lisbon Falls ME 04252-1138 |
| Mailing Address |
244 Veranda St Unit 2 Portland ME 04103-5554 |
| Practice Telephone | 2074074301 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |
| Authorized Official Name | DR. JENNA PULKKA (DENTIST) |
| Authorized Official Telephone | 2077519404 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 4065 | ME | Dental Providers |
| Street Address |
568 LISBON ST SUITE 1 |
| City | LISBON FALLS |
| State | ME |
| Zip Code | 04252-1138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528221116 | Jenna T Pulkka | Dentist | 568 Lisbon St, Suite 1, Lisbon Falls, ME 04252-1138 | 2008-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093144974 | Denys Lynn Robertson | Occupational Therapist | 714 Lisbon St, Lisbon Falls, ME 04252 | 2013-11-01 |
| 1912022351 | Phillip A Carter | Family Medicine | 583 Lisbon Rd., Lisbon Falls, ME 04252 | 2007-03-21 |
| 1942443056 | Ashley Michelle Wood | Massage Therapist | 16 Main St, Lisbon Falls, ME 04252 | 2009-04-20 |
| 1801028428 | Jeffrey F Charest | Pharmacist | 575 Lisbon St, Lisbon Falls, ME 04252-1114 | 2009-08-15 |
| 1417028796 | Rite Aid of Maine Inc | Durable Medical Equipment & Medical Supplies | 575 Lisbon Street, Lisbon Falls, ME 04252-1114 | 2006-11-10 |
| 1831701747 | Justin William Richards | Pharmacist | 575 Lisbon St, Lisbon, ME 04252-1114 | 2020-08-21 |
| 1932624939 | Walgreen Co | Pharmacy | 575 Lisbon St, Lisbon Falls, ME 04252-1114 | 2017-08-10 |
| 1245784891 | William Torrey Collinson | Pharmacist | 575 Lisbon St, Lisbon Falls, ME 04252-1114 | 2016-08-12 |
| 1508310871 | Tyson Fredriksen | Pharmacist | 575 Lisbon St, Lisbon Falls, ME 04252-1114 | 2016-08-04 |
| 1063898419 | Charles Cooper | Pharmacist | 575 Lisbon St, Lisbon Falls, ME 04252-1114 | 2015-08-08 |
| Find all providers in zip 04252 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354559 | Wes Mills | Dentist | 58 Portland Rd Ste 5, Kennebunk, ME 04043-6651 | 2020-10-20 |
| 1871119297 | Alexander Katanov | Dentist | 10 Market Sq Ste 3, South Paris, ME 04281-1573 | 2020-06-22 |
| 1720601321 | Margaret Mary Ellen Palmer | Dentist | 80 Pleasant Street, Brunswick, ME 04011-2203 | 2020-05-19 |
| 1053941849 | North Pond Dental Care | Dentist | 2467 Altantic Hwy, Warren, ME 04864 | 2020-01-21 |
| 1972156727 | Wanho Lew | Dentist | 127 Topsham Fail Mall Rd., Topsham, ME 04086 | 2019-07-22 |
| 1093372906 | Kevin Wright | Dentist | 99 Oak St, Ellsworth, ME 04605-1622 | 2019-05-27 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1871088070 | Hong Na Yang | Dentist | 122 Academy Street, Presque Isle, Presque Isle, ME 04769 | 2018-06-29 |
| 1801381686 | John Stanley Skvorak IIi | Dentist | 290 Bridgton Rd, Westbrook, ME 04092-3753 | 2018-06-25 |
| 1487175550 | Emily Abbie Burns | Dentist | 125-126 Shops Way, Biddeford, ME 04005 | 2017-06-29 |
| Find all providers with the same taxonomy | ||||
| City | LISBON FALLS |
| Zip Code | 04252 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.