Individual provider Active NPI

Ning Yu

  • Periodontics
  • Portland, ME
National Provider Identifier
1477287373
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE4930 Issued in ME
Practice address
650 Brighton Ave
Portland, ME 04102-1035
Phone
(207) 614-7487
NPI assigned
Jul 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 05087 NH
Periodontics 1223P0300X DE4930 ME Primary

Addresses

Primary practice location

650 Brighton Ave
Portland, ME 04102-1035

Mailing address

245 First St # 6108
Cambridge, MA 02142-1200
Phone (919) 457-2108

Other practice location 1

60 Hancock Rd
Peterborough, NH 03458-1107
Phone (603) 924-3350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE4930MEMDPeriodontist
05087NHMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Raynor Dental Peterborough, PLLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1477287373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FIRST ST # 6108",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421200",
            "telephone_number": "919-457-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021035",
            "telephone_number": "207-614-7487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Hancock Rd",
            "address_purpose": "LOCATION",
            "city": "Peterborough",
            "state": "NH",
            "postal_code": "034581107",
            "country_code": "US",
            "telephone_number": "603-924-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YU",
        "first_name": "NING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NH",
            "license": "05087",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ME",
            "license": "DE4930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.