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EVERGREEN WOODS DENTISTRY
NPI 1104691096
Dentist - General Practice in Bangor, ME

Active since November 20, 2023
700 MOUNT HOPE AVE STE 610, BANGOR, ME 04401(207) 945-5952(207) 945-5761 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Evergreen Woods Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN WOODS DENTISTRY (NPI 1104691096) is a healthcare organization registered as a general practice in Bangor, Maine and active in the NPI registry since November 2023. The organization lists Brandon Jolley, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1104691096
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBRANDON JOLLEY DDS PA LLC
Location Address700 MOUNT HOPE AVE STE 610Bangor, ME 04401-5673
Mailing Address700 Mount Hope Ave Ste 610Bangor, ME 04401-5673 · (207) 945-5952 · Fax (207) 945-5761
Phone(207) 945-5952
Fax(207) 945-5761
Organization SubpartNo
Authorized OfficialBrandon JolleyOwner/dentist · (505) 401-4923
Enumeration DateNovember 20, 2023
Last NPPES UpdateNovember 28, 2023
NPPES CertifiedNovember 28, 2023
✔ NPI 1104691096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

700 MOUNT HOPE AVE STE 610, Bangor, ME 04401
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Other Names 2

Doing Business AsEvergreen Woods Dentistry
Doing Business AsEvergreen Woods Dental

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSEPH LIVINGSTON DDS
Dentist
700 MOUNT HOPE AVE STE 610
BANGOR, ME 04401
Penobscot County (207) 945-5952
DR. BRYAN BOUCHARD DMD
Dentist (General Practice)
700 MOUNT HOPE AVE STE 610
BANGOR, ME 04401
Penobscot County (207) 945-5952

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brandon Jolley Dds PA LLC's NPI number?

The NPI number for Brandon Jolley Dds PA LLC is 1104691096. It was assigned to this organization in the NPPES registry on November 20, 2023. The provider is doing business as Evergreen Woods Dentistry and Evergreen Woods Dental.

Where is Brandon Jolley Dds PA LLC located?

Brandon Jolley Dds PA LLC is located at 700 Mount Hope Ave Ste 610, Bangor, ME 04401. The listed phone number is (207) 945-5952.

What is Brandon Jolley Dds PA LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Brandon Jolley Dds PA LLC was last updated on November 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.