Roosevelt Dental, P.A.

Roosevelt Dental, P.A. is a healthcare organization registered as General Practice Dentistry in Windham, ME, holding Type 2 (organization) NPI 1194084731 since 2012. The authorized official on file is Eugene Kim, Owner.

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NPI	1194084731
Entity type	Organization (Type 2)
Legal business name	Roosevelt Dental, P.A.
Practice address	840 ROOSEVELT TRL, Windham, ME, 04062
Phone	2078945580
Fax	2078945590
Enumeration date	2012-05-15
Last updated in NPPES	2012-05-15

Authorized official

Name	Eugene Kim
Title	Owner
Phone	2078945580

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
1223G0001X	General Practice Dentistry	Primary	4101	ME

Copy-ready billing details

Provider: Roosevelt Dental, P.A.
NPI: 1194084731
Taxonomy: 1223G0001X (General Practice Dentistry)
Address: 840 ROOSEVELT TRL, Windham, ME, 04062

Providers at this address

NPI	Name	Type	Specialty	Location
1992258669	Georgia Smith	Individual	Dentist	Windham, ME
1144759044	Bradford Wenzel	Individual	General Practice Dentistry	Windham, ME
1487260527	Sameera Bhandari	Individual	General Practice Dentistry	Windham, ME
1346024916	Kwonduk Jung	Individual	Dentist	Windham, ME

Verify this record

Cross-check NPI 1194084731 against the authoritative CMS record: view Roosevelt Dental, P.A. on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2012-05-15. Verify at npiregistry.cms.hhs.gov.

Where is Roosevelt Dental, P.A. located?

The practice location on file with NPPES is in Windham, ME.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2012-05-15.