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PENOBSCOT VALLEY DERMATOLOGY, P.A.
NPI 1952536880
Specialist in Bangor, ME

Active since May 21, 2009
90 RIDGEWOOD DRIVE, BANGOR, ME 04401(207) 942-0669(207) 947-3143 Get Directions Write a Review

NPPES record last updated: June 3, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Penobscot Valley Dermatology, P.a. NPPES

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

PENOBSCOT VALLEY DERMATOLOGY, P.A. (NPI 1952536880) is a healthcare organization registered as a specialist in Bangor, Maine and active in the NPI registry since May 2009. The organization lists Jeffrey Dean Pittis, Dermatologist, as its authorized official.

NPPES Registry Identity

NPI1952536880
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePENOBSCOT VALLEY DERMATOLOGY, P.A.
Location Address90 RIDGEWOOD DRIVEBangor, ME 04401-2652
Mailing Address90 Ridgewood DriveBangor, ME 04401-2652 · (207) 942-0669 · Fax (207) 947-3143
Phone(207) 942-0669
Fax(207) 947-3143
Organization SubpartNo
Authorized OfficialJeffrey Dean PittisDermatologist · (207) 942-0669
Enumeration DateMay 21, 2009
Last NPPES UpdateJune 3, 2009
✔ NPI 1952536880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in ME · ME013153
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
90 RIDGEWOOD DRIVE, Bangor, ME 04401
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Other Identifiers 1

Medicare UPINE98841ME

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 20D2187500

Penobscot Valley Dermatology · Orono, ME
Expired · Jul 1, 2026
CLIA Number20D2187500
Laboratory TypePhysician Office
Certificate Effective DateJuly 2, 2024
Certificate Expiration DateJuly 1, 2026
Laboratory DirectorDr. Orville A. Hartford
Laboratory Phone(207) 942-0669
Laboratory LocationPenobscot Valley Dermatology381 Main St, Orono, ME 04473
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Penobscot Valley Dermatology, P.A.'s NPI number?

The NPI number for Penobscot Valley Dermatology, P.A. is 1952536880. It was assigned to this organization in the NPPES registry on May 21, 2009.

Where is Penobscot Valley Dermatology, P.A. located?

Penobscot Valley Dermatology, P.A. is located at 90 Ridgewood Drive, Bangor, ME 04401. The listed phone number is (207) 942-0669.

What is Penobscot Valley Dermatology, P.A.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Penobscot Valley Dermatology, P.A. was last updated on June 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.