CLASSIC DENTURES OF MAINE (NPI# 1396974390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396974390 |
| Entity Type | Organization |
| Organization Name | CLASSIC DENTURES OF MAINE |
| Practice Address |
61 Hersey Ave Bangor ME 04401-4443 |
| Practice Telephone | 2079421743 |
| Mailing Telephone | 2079421743 |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2009-07-11 |
| Authorized Official Name | DR. JOSEPH S KINGSTON (PRESIDENT) |
| Authorized Official Telephone | 2079421743 |
| Authorized Official Credential | ED.D ; LD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122400000X | Denturist | 5515 | ME | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 434321199 | 05 |
| Street Address |
61 HERSEY AVE |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-4443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700015526 | Joseph S Kingston | Denturist | 61 Hersey Ave, Bangor, ME 04401-4443 | 2009-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053546663 | Rebecca J Connor | Denturist | 348 Buck St, Bangor, ME 04401-5932 | 2009-05-27 |
| 1972047470 | Elizabeth Laura Stevens | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2016-12-19 |
| 1467996330 | Gary Boudreau | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2016-12-13 |
| 1700015526 | Joseph S Kingston | Denturist | 61 Hersey Ave, Bangor, ME 04401-4443 | 2009-07-14 |
| 1396970802 | Stephanie R Buxton | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2009-05-28 |
| 1366677965 | Austin J Carbone | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2009-05-27 |
| 1528293123 | Megan E Higgins | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2009-05-27 |
| 1003041609 | Sherry M Bodge | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2009-05-27 |
| 1629203385 | Patrick D Allen | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2009-05-26 |
| 1750501318 | New England Denture Center | Denturist | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2007-04-26 |
| Find all providers in BANGOR | ||||
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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.