DR. DONALD LEON THERIAULT (NPI# 1669502795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669502795 |
| Entity Type | Individual |
| Full Name | DR. DONALD LEON THERIAULT |
| Credential | DMD |
| Practice Address |
595 Brighton Ave Portland ME 04102-2322 |
| Practice Telephone | 2077741471 |
| Mailing Telephone | 2077741471 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
2974 | ME | Dental Providers |
| Street Address |
595 BRIGHTON AVE |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770684177 | David S Lowell | Optometrist | 595 Brighton Ave, Portland, ME 04102-2322 | 2006-09-26 |
| 1811553845 | Charles Morse Johnson | Optometrist | 595 Brighton Ave, Portland, ME 04102-2322 | 2019-05-15 |
| 1548667348 | Eyes On Rosemont LLC | Optometrist | 595 Brighton Ave, Portland, ME 04102-2322 | 2014-11-24 |
| 1134353618 | Eyes On Rosemont LLC | Optometrist | 595 Brighton Ave, Portland, ME 04102-2322 | 2009-05-12 |
| 1336297704 | Michael David Pirone | Optometrist | 595 Brighton Ave, Portland, ME 04102-2322 | 2007-01-08 |
| 1417025503 | Tricia Lynn Pirone | Optometrist | 595 Brighton Ave, Portland, ME 04102-2322 | 2006-11-30 |
| 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 | 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 |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1730632266 | Samar Shaikh | Dentist | 716 Stevens Ave # 204, Portland, ME 04103 | 2016-08-02 |
| 1730472986 | Wilson D Lee | Dentist | 315 Nw Lost Springs Ter, #401, Portland, OR 97229-6444 | 2011-05-20 |
| 1184954422 | Kamran Haghighat Bds Ms PC | Dentist | 833 Sw 11th Ave Ste 1020, Portland, OR 97205-2124 | 2010-01-08 |
| 1225292121 | Harjit Singh Sehgal | Dentist | 2730 Sw Moodey Ave, Clsb-5n034, Portland, OR 97201 | 2008-07-10 |
| 1467516211 | Chirgwin & Herriges, LLC | Dentist | 1130 Se 122nd Ave, Portland, OR 97233-1112 | 2006-12-19 |
| 1568534519 | Trang N Pham | Dentist | 10356 Ne Wasco St, Portland, OR 97220 | 2006-11-14 |
| 1811086887 | Winthrop B. Carter | Dentist | 611 Sw Campus Drive, Ohsu School of Dentistry, Sd 177, Portland, OR 97239 | 2006-10-11 |
| 1295828069 | Southern Maine Periodontal Assoc Pa | Dentist | 276 Canco Rd, Portland, ME 04103 | 2006-10-02 |
| 1598702151 | Angela Blizzard | Dentist | 7107 Sw Macadam Ave, Portland, OR 97219-3075 | 2006-06-01 |
| 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.