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SOUTHERN MAINE PERIODONTAL ASSOC PA
NPI 1295828069
Dentist - Periodontics in Portland, ME

Active since October 02, 2006
276 CANCO RD, PORTLAND, ME 04103(207) 780-1822(207) 780-6022 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Maine Periodontal Assoc Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN MAINE PERIODONTAL ASSOC PA (NPI 1295828069), doing business as Denise M Theriault Dmd, is a healthcare organization registered as a periodontics in Portland, Maine and active in the NPI registry since October 2006. The organization lists Denise M Theriault, Owner, as its authorized official.

NPPES Registry Identity

NPI1295828069
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameSOUTHERN MAINE PERIODONTAL ASSOC PA
Location Address276 CANCO RDPortland, ME 04103
Mailing Address276 Canco RdPortland, ME 04103 · (207) 780-1822 · Fax (207) 780-6022
Phone(207) 780-1822
Fax(207) 780-6022
Organization SubpartNo
Authorized OfficialDenise M TheriaultOwner · (207) 780-1922
Enumeration DateOctober 2, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1295828069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in ME · 3390
Definition
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.
276 CANCO RD, Portland, ME 04103
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Other Names 1

Former Legal Business NameDenise M Theriault Dmd

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL BENNETT DMD
Dentist
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 874-1025
AUDREY STACK DDS
Dentist
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 874-1025
JAMES E JACKSON DMD
Dentist
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 874-1025
EDWARD G SEBOK DMD
Dentist (Endodontics)
276 CANCO RD, GRANITE HEIGHTS
PORTLAND, ME 04103
Cumberland County (207) 772-7431
LAWRENCE JACOBY DMD, MPH
Dentist
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 874-1025
DR. ALAN DAVID NEWTON DMD
Dentist (Prosthodontics)
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 773-6177
DR. DENISE M THERIAULT D.M.D.
Dentist (Periodontics)
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 780-1822
DR. FRANCESCO ANTONIO MUSCIANO DDS
Dentist (Prosthodontics)
276 CANCO RD
PORTLAND, ME 04103
Cumberland County (207) 773-6177

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Maine Periodontal Assoc PA's NPI number?

The NPI number for Southern Maine Periodontal Assoc PA is 1295828069. It was assigned to this organization in the NPPES registry on October 2, 2006. The provider was formerly known as Denise M Theriault Dmd.

Where is Southern Maine Periodontal Assoc PA located?

Southern Maine Periodontal Assoc PA is located at 276 Canco Rd, Portland, ME 04103. The listed phone number is (207) 780-1822.

What is Southern Maine Periodontal Assoc PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Southern Maine Periodontal Assoc PA was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.