Healthcare Provider Details

I. General information

NPI: 1427451285
Provider Name (Legal Business Name): JENNIFER CAPLIN D.M.D. M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLLEGE ST
PORTLAND ME
04103-2617
US

IV. Provider business mailing address

582 LEDGE RD
NORTH YARMOUTH ME
04097-6970
US

V. Phone/Fax

Practice location:
  • Phone: 207-227-4747
  • Fax:
Mailing address:
  • Phone: 847-924-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019.028891
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS040639
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number061517
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN4917
License Number StateME
# 5
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number021.002685
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS040639
License Number StatePA
# 7
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDEN4917
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: