Individual provider Active NPI

Meaghan Bradley, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Portland, ME
National Provider Identifier
1225533359
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN4958 Issued in ME
Practice address
750 Stevens Ave
Portland, ME 04103-2623
Phone
(207) 221-4747
NPI assigned
Mar 29, 2018
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN4958 ME Primary

Addresses

Primary practice location

750 Stevens Ave
Portland, ME 04103-2623

Mailing address

716 Stevens Ave
Portland, ME 04103-2693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 20, 2023 through Dec 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN4958MEMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Maine Oral and Maxillofacial Surgery PA Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1225533359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032623",
            "telephone_number": "207-221-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MEAGHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "DEN4958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.