Provider Demographics
NPI:1578697686
Name:ORTENGREN, JAMES CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:ORTENGREN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1320
Mailing Address - Country:US
Mailing Address - Phone:207-799-1457
Mailing Address - Fax:
Practice Address - Street 1:463 COTTAGE RD
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-4924
Practice Address - Country:US
Practice Address - Phone:207-799-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME31911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice