| Doctor Name: | DR. JONATHAN D SHENKIN |
| NPI Number: | 1023131679 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS, MPH |
| License Number: | 3649 |
| Business Practice Address: | 792 Stillwater Ave Bangor, ME - 044013617 |
| Business Phone Number: | 2079476733 |
| Business Fax Number: | 2079476760 |
| Mailing Address: | 792 Stillwater Ave, BANGOR |
| State: | ME |
| Postal Code: | 044013617 |
| Phone Number: | 2079476733 |
| Fax Number: | 2079476760 |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 3649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |