=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578495628
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHORELINE DENTAL HYGIENE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2026
-----------------------------------------------------
Last Update Date | 06/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1164 BAR HARBOR RD
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04605-6025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-667-0157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 138 HIGH ST # 196
-----------------------------------------------------
City | ELLSWORTH
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04605-1712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-667-0157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | INDEPENDANT DENTAL HYGIENIST/OWNER
-----------------------------------------------------
Name | MELANIE ANNE LILES
-----------------------------------------------------
Credential | IPDH, RDH
-----------------------------------------------------
Telephone | 229-942-6001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------