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NPI Code Detail

MEDICARE: DR. MICHELLE DENISE LUND D.D.S.

MEDICARE: DR. MICHELLE DENISE LUND D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist11547MN
2122300000XDentistDEN5286ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538246319
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE DENISE LUND D.D.S.
Provider Business Mailing Address
First Line : 716 STEVENS AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2693
Country : US
Telephone Number : 207-221-4784
Fax Number : 507-934-0148
Provider Business Practice Location Address
First Line : 1 COLLEGE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2617
Country : US
Telephone Number : 207-221-4784
Fax Number : 507-934-0148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/07/2025

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