Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Thomas J Vanidestine Jr., DC, CCSP

Individual provider Chiropractor · NPI 1538108022

Dr. Thomas J Vanidestine Jr., DC, CCSP is a Chiropractic in Bangor, Maine. Qualified in 1990, 36 years ago. Practices with Katahdin Valley Health Center, a 68-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
36
Licensed in
ME
In the registry since
2006
What do these letters mean?
DC — Doctor of Chiropractic
A licensed chiropractor.

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Practice location Address checks out

336 Mount Hope Ave Ste 11
Bangor, ME 04401-4236
Phone: (207) 942-2800
Fax: (207) 990-2362
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence CR814 (ME)

Record details

NPI number1538108022
Entity typeIndividual (Type 1)
GenderMale
Credentials DC , CCSP
Sole proprietorYes
NPI enumeratedJune 6, 2006
Last updated in NPPESDecember 1, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCHIROPRACTIC
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Katahdin Valley Health Center — 68 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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