Downeast Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DOWNEAST PEDIATRIC DENTISTRY PLLC

Practice address

888 Brighton Ave
Portland, ME 04102-1004

Phone

(207) 772-4111

Fax

(207) 761-6953

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Mariah Thibault

Title

Chief Operations Officer

Phone

(520) 276-2220

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Louis Jackson III

  • Pediatric Dentistry
  • Albuquerque, NM
  • NPI 1285040337
  NPD
• Susan J Russett-Collett, DDS

  • Pediatric Dentistry
  • Portland, ME
  • NPI 1083650436
  NPD (past)

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1720656705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 N COUNTRY CLUB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857164591",
            "telephone_number": "520-326-8516",
            "fax_number": "520-326-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021004",
            "telephone_number": "207-772-4111",
            "fax_number": "207-761-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNEAST PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "THIBAULT",
        "authorized_official_first_name": "MARIAH",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "520-276-2220"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Douglass, NNP
• Kaylee Dow
• Mary Dowd, MD
• Samantha Dowling, CTRS, MSRT, LMT, PTA
• Walter Harold Dowling, PA-C
• Lisa Chapman Downey, CCC-SLP
• Nicole Marie Downey
• Holly Downing, PHARMD
• Robert Earl Downing II, PA-C
• Kyle Doyle, PHARMD

• Pediatric Dentistry in Portland, ME
• Providers in Portland, ME by specialty
• Pediatric Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.