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RUSSELL J COLLETT DDS
NPI 1629173711
Oral & Maxillofacial Surgery in Portland, ME

Active since September 13, 2006Opted out of Medicare · through Mar 31, 2028
1601 CONGRESS STREET, PORTLAND, ME 04102(207) 772-8055(207) 772-8752 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 17, 2018, Nov 3, 2017 (2 updates tracked since 2017).

About Russell J Collett Dds NPPES

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

RUSSELL J COLLETT DDS (NPI 1629173711) is an individual oral & maxillofacial surgery provider in Portland, Maine, licensed in Maine (3009) and active in the NPI registry since September 2006. He has opted out of Medicare through March 31, 2028 and remains eligible to order and refer and maintains a secondary practice location in Rockport.

NPPES Registry Identity

NPI1629173711
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameRUSSELL J COLLETTCredential: DDS
Location Address1601 CONGRESS STREETPortland, ME 04102
Mailing Address1601 Congress StreetPortland, ME 04102 · (207) 772-8055 · Fax (207) 772-8752
Phone(207) 772-8055
Fax(207) 772-8752
Sole ProprietorYes
Enumeration DateSeptember 13, 2006
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1629173711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in ME · 3009
Definition
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.
Also ListedDentist · Oral and Maxillofacial PathologyTaxonomy 1223P0106X · License 3009 (ME)
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 3009 (ME)
Also ListedDentist · Oral and Maxillofacial RadiologyTaxonomy 1223X0008X · License 3009 (ME)
1601 CONGRESS STREET, Portland, ME 04102
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Secondary Practice Location 1

Location 1823 Commercial StRockport, ME 04856-4243 · Phone (207) 772-8055 · Fax (207) 772-8752

Other Identifiers 1

Medicaid221210000ME

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Russell J Collett Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 31, 2014 through March 31, 2028.

Opt-Out Effective DateMarch 31, 2014
Opt-Out In Effect ThroughMarch 31, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Russell Collett's NPI number?

The NPI number for Russell Collett is 1629173711. It was assigned to this individual provider in the NPPES registry on September 13, 2006.

Where is Russell Collett located?

Russell Collett practices at 1601 Congress Street, Portland, ME 04102. The listed phone number is (207) 772-8055.

What is Russell Collett's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Russell Collett enrolled in Medicare?

No. Russell Collett has opted out of Medicare through March 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Russell Collett was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.