OrganizationActive
Southern Maine Periodontal Assoc PA
NPI 1295828069 · Periodontics · Portland, ME
Southern Maine Periodontal Assoc PA is a Periodontics organization in Portland, ME (NPI 1295828069).
Provider details
- NPI number
- 1295828069
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Denise Theriault, Owner(207) 780-1922
- License
- 3390 (ME)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
276 Canco Rd
Portland, ME 04103
Phone: (207) 780-1822
Fax: (207) 780-6022
Street-level locationGet directions
Mailing address
276 Canco Rd
Portland, ME 04103
Other names (DBA / former)
- Former legal business name
- Denise M Theriault DMD
Registry dates
- Enumerated
- 2006-10-02
- Last updated
- 2020-08-22
Frequently asked questions
- What is Southern Maine Periodontal Assoc PA's NPI number?
- Southern Maine Periodontal Assoc PA's National Provider Identifier (NPI) is 1295828069, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Maine Periodontal Assoc PA?
- Southern Maine Periodontal Assoc PA is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Southern Maine Periodontal Assoc PA located?
- Southern Maine Periodontal Assoc PA's practice location on file with NPPES is 276 Canco Rd, Portland, ME 04103.
- What is Southern Maine Periodontal Assoc PA's phone number?
- The practice phone number listed in the NPPES registry for Southern Maine Periodontal Assoc PA is (207) 780-1822.
- Who is the authorized official for Southern Maine Periodontal Assoc PA?
- The authorized official listed on Southern Maine Periodontal Assoc PA's NPPES record is Denise Theriault, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Maine Periodontal Assoc PA's NPI active?
- Yes — Southern Maine Periodontal Assoc PA's NPI (1295828069) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.