Supritha Nilam, DDS is a
Oral & Maxillofacial Surgery based in Ellsworth, Maine. Supritha Nilam is licensed to practice in California (license number 106194) and her current practice location is
72 Beechland Rd, Ellsworth, Maine. She can be reached at her office (for appointments etc.) via phone at
(207) 667-6789.
NPI number for Supritha Nilam is 1629597562 and her current mailing address is 10833 Le Conte Avenue, A0156 Chs, Los Angeles, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1629597562.
Healthcare Provider's Profile
Full Name | Supritha Nilam |
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Gender | Female |
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Speciality | Oral & Maxillofacial Surgery |
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Location | 72 Beechland Rd, Ellsworth, Maine |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1629597562
- Provider Enumeration Date: 09/12/2017
- Last Update Date: 01/26/2023
Medical Identifiers
Medical identifiers for Supritha Nilam such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629597562 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | DEN4589 (Maine) | Secondary |
204E00000X | Oral & Maxillofacial Surgery | 106194 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Supritha Nilam is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Supritha Nilam, DDS 10833 Le Conte Avenue, A0156 Chs, Los Angeles, CA 90095 Ph: (310) 825-0834 | Supritha Nilam, DDS 72 Beechland Rd, Ellsworth, ME 04605-2533 Ph: (207) 667-6789 |
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