GREATER PORTLAND ENDODONTICS PA
NPI 1316474802
Dentist - Endodontics in Portland, ME

Active since May 16, 2017
1330 CONGRESS ST, PORTLAND, ME 04102(207) 879-0010 Get Directions Write a Review

NPPES record last updated: May 16, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Dentist
  • Endodontics

About GREATER PORTLAND ENDODONTICS PA

This page provides the complete NPI Profile along with additional information for Greater Portland Endodontics Pa, a provider established in Portland, Maine operating as a Dentist, focusing in endodontics . The healthcare provider is registered in the NPI registry with number 1316474802 assigned on May 2017. The practitioner's primary taxonomy code is 1223E0200X with license number 4291 (ME). The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Daniel C Fackrell Dmd (Endodontist)

NPI
1316474802 Verify this NPI
Provider Name
GREATER PORTLAND ENDODONTICS PA
Entity Type
Organization
Location Address
1330 CONGRESS ST PORTLAND, ME 04102
Location Phone
(207) 879-0010
Mailing Address
9 HOLLY DR CUMBERLAND, ME 04021
Mailing Phone
(860) 716-6856
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-16-2017
Last Update Date
05-16-2017
Code Navigator

A dentist like Greater Portland Endodontics Pa is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist Endodontics

Taxonomy Code
1223E0200X
Type
Dental Providers
License No.
4291
License State
ME
Taxonomy Description
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. DANIEL C FACKRELL DMD

Authorized Official Title
ENDODONTIST
Authorized Official Phone
(207) 879-0010

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Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Dentist (Oral and Maxillofacial Pathology)
1330 CONGRESS ST
PORTLAND, ME 04102
Dentist
1330 CONGRESS ST
PORTLAND, ME 04102
Dentist
1330 CONGRESS ST
PORTLAND, ME 04102
Dentist (Oral and Maxillofacial Pathology)
1330 CONGRESS ST
PORTLAND, ME 04102
Dentist
1330 CONGRESS ST
PORTLAND, ME 04102

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316474802, enumerated as an "organization" on May 16, 2017.

The provider is located at 1330 CONGRESS ST PORTLAND, ME 04102 and the phone number is (207) 879-0010.

Dentist with taxonomy code 1223E0200X and a focus in Endodontics.