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MAINEHEALTH NPI 1073702288


NPI Information

NPI: 1073702288
Provider Name: MAINEHEALTH

Doing Business As: MMC ORAL SURGERY

Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Organization
Address:
22 BRAMHALL ST
PORTLAND, ME
ZIP 04102
Phone: (207) 871-4078
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MAINEHEALTH is an oral maxillofacial surgery in Portland, ME. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. MAINEHEALTH NPI is 1073702288. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mmc Oral Surgery.

The provider's business location address is:

22 BRAMHALL ST
PORTLAND, ME
ZIP 04102-134
Phone: (207) 871-4078

The provider's authorized official is Lugene Anthony Inzana .
The authorized official title is Associate Cfo and has the following contact phone number (207) 662-3538.

The enumeration date for this NPI number is 10/24/2007 and was last updated on 5/11/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryNo
2204E00000XOral & Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1119910022MEDICAIDMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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