Provider Demographics
NPI:1861708703
Name:DEAN, KRISTIN MICHELLE (MD)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MICHELLE
Last Name:DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 CALIFORNIA ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5424
Mailing Address - Country:US
Mailing Address - Phone:800-997-6196
Mailing Address - Fax:
Practice Address - Street 1:35 CANAL ST STE 401
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7773
Practice Address - Country:US
Practice Address - Phone:415-504-3838
Practice Address - Fax:415-504-1367
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09598600207Q00000X
TN52025207Q00000X
MDD78517207Q00000X
SC37546207Q00000X
VA0101257326207Q00000X
GA073191207Q00000X
NC2014-02120207Q00000X
PAMD453288207Q00000X
NY277355207Q00000X
WV26122207Q00000X
KY47744207Q00000X
FLME121654207Q00000X
MI4301106409207Q00000X
RIMD14776207Q00000X
CAA118149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine