NORTHEAST PERIODOANTAL ASSOCIATES (NPI# 1396967824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396967824 |
| Entity Type | Organization |
| Organization Name | NORTHEAST PERIODOANTAL ASSOCIATES |
| Practice Address |
20 Penn Plaza, Suite 32 Bangor ME 04401 |
| Practice Telephone | 2079412300 |
| Practice Fax Number | 2079419683 |
| Mailing Telephone | 2079412300 |
| Mailing Fax Number | 2079419683 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LAURA REIDY (PERIODONTIST) |
| Authorized Official Telephone | 2079412300 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
3092 | ME | Dental Providers |
| Street Address |
20 PENN PLAZA, SUITE 32 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260936 | Laura Ann Reidy | Dentist | 20 Penn Plz, Suite 32, Bangor, ME 04401-3620 | 2005-10-27 |
| 1649214859 | Michael P Goldberg | Dentist | 700 Mount Hope Ave, Suite 410, Bangor, ME 04401-5691 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730632266 | Samar Shaikh | Dentist | 716 Stevens Ave # 204, Portland, ME 04103 | 2016-08-02 |
| 1386866598 | Andrew L. Allen | Dentist | 117 Pleasant St, Brunswick, ME 04011-2217 | 2007-05-03 |
| 1750502159 | Katherine Dunn Wilson | Dentist | 74 State Rd Ste 102, Kittery, ME 03904-1562 | 2007-05-01 |
| 1609943844 | Michael R Nawfel | Dentist | 46b First Park Drive, Oakland, ME 04963 | 2006-11-30 |
| 1003986589 | Peter Rene Then | Dentist | 254 Western Avenue, South Portland, ME 04106 | 2006-11-09 |
| 1295828069 | Southern Maine Periodontal Assoc Pa | Dentist | 276 Canco Rd, Portland, ME 04103 | 2006-10-02 |
| 1609979012 | Jeffrey Ian Saltz | Dentist | 74 State Rd, Suite 102, Kittery, ME 03904-1564 | 2006-09-07 |
| 1831101625 | Jeffrey Alan Brackett | Dentist | 243 Us Rte #1, Ste #1, Scarbono, ME 04074 | 2006-08-12 |
| 1205351699 | Adam Saltz | Dentist | 254 Western Ave, South Portland, ME 04106-2410 | 2017-08-07 |
| 1699126250 | Anuja Doshi | Dentist | 716 Stevens Ave, Portland, ME 04103-2656 | 2016-06-24 |
| Find all providers with the same taxonomy | ||||
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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.