RUSSELL J COLLETT (NPI# 1629173711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629173711 |
Entity Type | Individual |
Full Name | RUSSELL J COLLETT |
Credential | DDS |
Practice Address |
1601 Congress Street Portland ME 04102 |
Practice Telephone | 2077728055 |
Practice Fax Number | 2077728752 |
Mailing Telephone | 2077728055 |
Mailing Fax Number | 2077728752 |
Enumeration Date | 2006-09-13 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
3009 | ME | Dental Providers |
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3009 | ME | Dental Providers |
N | 1223X0008X |
Dentist Specialization: Oral and Maxillofacial Radiology |
3009 | ME | Dental Providers |
Y | 204E00000X | Oral & Maxillofacial Surgery | 3009 | ME | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ME | 221210000 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
823 Commercial St, Rockport, ME 048564243 | 2077728055 | 2077728752 |
Street Address |
1601 CONGRESS STREET |
City | PORTLAND |
State | ME |
Zip Code | 04102 |
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 | 204E00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Oral & Maxillofacial Surgery |
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. |
Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346249281 | Bryce Earl Potter | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Ste 300, Portland, OR 97209-1453 | 2005-07-20 |
1053864561 | Karl Cuddy | Oral & Maxillofacial Surgery | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2016-08-01 |
1104209386 | Felix Wiyanto Sim | Oral & Maxillofacial Surgery | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2015-07-07 |
1407109937 | Providence Health & Services - Oregon | Oral & Maxillofacial Surgery | 4805 Ne Glisan St, Suite 6n50, Portland, OR 97213-2933 | 2012-10-22 |
1447525852 | Brett A. Ueeck Dmd, Md, PC | Oral & Maxillofacial Surgery | 11786 Sw Barnes Rd Ste 110, Portland, OR 97225-5926 | 2012-03-19 |
1588939961 | Marcus Aaron Couey | Oral & Maxillofacial Surgery | 1849 Nw Kearney St Ste 300, Portland, OR 97209-1453 | 2012-03-18 |
1043537707 | Allen C Cheng | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Suite 300, Portland, OR 97209 | 2010-04-21 |
1043415870 | Ashish A Patel | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Suite 300, Portland, OR 97209 | 2007-06-20 |
1235332834 | Daniel Petrisor | Oral & Maxillofacial Surgery | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2007-06-09 |
1790889376 | Maine Medical Partners | Oral & Maxillofacial Surgery | 22 Bramhall St, Dept of Surgery, Portland, ME 04102-3134 | 2006-09-12 |
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.