MAINE COAST ORAL SURGERY


Address: 1601 Congress St, Portland, ME 04102-2102
Phone: 2077728055

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
ME ORAL & MAXILLOFACIAL SURGERY 1780995712 01

Other Provider/Organization Names

Other Name Type Code
Portland Oral & Maxillofacial Surgery Former Legal Business Name - Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
823 Commercial St Unit 2, Rockport, ME 048564243 2077728055 2077728752

Office Location

Street Address 1601 CONGRESS ST
City PORTLAND
State ME
Zip Code 04102-2102

Providers in the same location

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
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Providers in the same zip code

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 Information

Taxonomy Code 1223P0106X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Pathology

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

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City PORTLAND
Zip Code 04102

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Dataset Information

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.

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