DR. SUSAN J RUSSETT-COLLETT (NPI# 1083650436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083650436 |
| Entity Type | Individual |
| Full Name | DR. SUSAN J RUSSETT-COLLETT |
| Credential | DDS |
| Practice Address |
888 Brighton Ave Portland ME 04102-1004 |
| Mailing Address |
3 Ledge Hill Rd Gorham ME 04038-2121 |
| Practice Telephone | 2077724111 |
| Mailing Telephone | 2078398149 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3008 | ME | Dental Providers |
| Street Address |
888 BRIGHTON AVE |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-1004 |
| 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 | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700374154 | Fox Kids Dentistry & Orthodontics II | Dentist | 1401 Se Morrison St Ste 120, Portland, OR 97214-2777 | 2018-05-01 |
| 1679924526 | Pediatric Dentistry of Portland LLC | Dentist | 2811 Ne Wasco St, Portland, OR 97232-1771 | 2016-06-22 |
| 1801183488 | World of Smiles, Pediatric Dentistry LLC | Dentist | 11790 Sw Barnes Rd Ste 280, Portland, OR 97225-5935 | 2011-07-05 |
| 1265696629 | Angela Dawn Boydston | Dentist | 2824 Ne Wasco St Ste 230, Portland, OR 97232-1772 | 2008-07-15 |
| 1972639623 | Anastacia M. Whitman | Dentist | 4548 N Albina Ave, Portland, OR 97217-3010 | 2007-02-26 |
| 1114088705 | Michael Biermann | Dentist | 5900 N Lombard St, Portland, OR 97203-4118 | 2006-12-13 |
| 1053408005 | Peter John Lax | Dentist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-09 |
| 1376646901 | Krista V Badger Dds PC | Dentist | 3839 Ne Tillamook St, Portland, OR 97212-5338 | 2006-09-07 |
| 1902827199 | Karole H Wilson D.m.d., PC | Dentist | 9370 Sw Greenburg Rd Ste T, Portland, OR 97223-5408 | 2006-07-22 |
| 1336146307 | Michael Charles Royse | Dentist | 511 Sw 10th Ave, Suite #810, Portland, OR 97205-2732 | 2005-07-05 |
| Find all providers in PORTLAND | ||||
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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.