MAINE COAST ORAL SURGERY (NPI# 1952717084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952717084 |
Entity Type | Organization |
Organization Name | MAINE COAST ORAL SURGERY |
Other Organization Name | PORTLAND ORAL & MAXILLOFACIAL SURGERY |
Practice Address |
1601 Congress St Portland ME 04102-2102 |
Practice Telephone | 2077728055 |
Practice Fax Number | 2077728752 |
Enumeration Date | 2014-07-09 |
Last Update Date | 2018-03-17 |
Authorized Official Name | DR. RUSSELL J COLLETT (ORAL SURGEON) |
Authorized Official Telephone | 2077728055 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
N | 1223X0008X |
Dentist Specialization: Oral and Maxillofacial Radiology |
Dental Providers | ||
Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ME | ORAL & MAXILLOFACIAL SURGERY | 1780995712 | 01 |
Other Name | Type Code |
---|---|
Portland Oral & Maxillofacial Surgery | Former Legal Business Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
823 Commercial St Unit 2, Rockport, ME 048564243 | 2077728055 | 2077728752 |
Street Address |
1601 CONGRESS ST |
City | PORTLAND |
State | ME |
Zip Code | 04102-2102 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023013257 | David T. Greenleaf | Orthopaedic Surgery | 1601 Congress St, Portland, ME 04102-2102 | 2005-06-15 |
1851850267 | Saco Bay Orthopaedic and Sports Physical Therapy, Inc | Durable Medical Equipment & Medical Supplies | 1601 Congress St, Portland, ME 04102-2102 | 2019-03-15 |
1144788209 | Saco Bay Orthopaedic and Sports Physical Therapy, Inc | Clinic/Center | 1601 Congress St, Portland, ME 04102-2102 | 2019-03-07 |
1235645946 | Spectrum Medical Group, Pa | Orthopaedic Surgery | 1601 Congress St, Portland, ME 04102-2102 | 2017-12-18 |
1518335892 | David R Kerr | Durable Medical Equipment & Medical Supplies | 1601 Congress St, Portland, ME 04102-2102 | 2015-09-03 |
1780995712 | Luke L'heureux | Dentist | 1601 Congress St, Portland, ME 04102-2102 | 2010-06-24 |
1447404462 | Mobile Medical Imaging Services Inc. | Radiology | 1601 Congress St, Suite 3, Portland, ME 04102-2102 | 2008-11-05 |
1760642243 | James A Wilkerson | Orthopaedic Surgery | 1601 Congress St, Portland, ME 04102-2102 | 2008-06-10 |
1619181930 | Orthopaedic & Sports Physical Therapy Clinic Pa | Physical Therapist | 1601 Congress St, Portland, ME 04102-2102 | 2007-05-09 |
1568523637 | Maine Orthopaedic Center, Pa | Orthopaedic Surgery | 1601 Congress St, Portland, ME 04102-2102 | 2006-12-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
Find all providers in zip 04102 |
Taxonomy Code | 1223P0106X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Pathology |
The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043374762 | Martin Dunn | Dentist | 1036 Brighton Ave, Unit A, Portland, ME 04102 | 2006-12-20 |
1629173711 | Russell J Collett | Dentist | 1601 Congress Street, Portland, ME 04102 | 2006-09-13 |
1548295520 | Richard Paul Lemieux | Dentist | 1330 Congress St, Portland, ME 04102-2144 | 2006-07-11 |
1508827478 | Wei-yuhg Yih | Dentist | 611 Sw Campus Dr, Sd-515, Portland, OR 97239-3001 | 2006-03-30 |
1407142540 | Molly Dee Cohen | Dentist | 716 Stevens Ave, Portland, ME 04103-2656 | 2011-06-28 |
1780995712 | Luke L'heureux | Dentist | 1601 Congress St, Portland, ME 04102-2102 | 2010-06-24 |
1497892475 | Richard P. Lemieux D.m.d., Pa | Dentist | 1330 Congress St, Portland, ME 04102-2144 | 2007-01-31 |
1255404836 | Paul L Auclair | Dentist | 22 Bramhall St, Portland, ME 04102-3134 | 2006-11-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669511374 | Robert Danny Moore | Dentist | 24 Penn Plz, Bangor, ME 04401-3620 | 2007-02-06 |
1518003094 | Mark Edward Grubb | Dentist | 37 Bower St, Bangor, ME 04401-4721 | 2007-01-30 |
1255474698 | Northeast Oral & Maxillofacial Surgery Associates P.a. | Dentist | 37 Bower St, Bangor, ME 04401-4721 | 2007-02-15 |
1073659538 | William Alexander Deighan | Dentist | 37 Bower St, Bangor, ME 04401-4721 | 2007-01-30 |
1255351664 | William Atherton Bagley | Dentist | 369 Main St, Lewiston, ME 04240-7030 | 2006-07-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.