Breakwater Dental, LLC
NPI 1811575202ActiveOrganization· Dentist, General Practice· South Portland, ME
Dentist, General Practice in South Portland, Maine, registered in NPPES in March 2021. The authorized official on file is Shilo Annis, DMD, Owner/Dentist.
Overview
| NPI | 1811575202 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 29, 2021 |
| Last updated in NPPES | Mar 29, 2021 |
| Certified by provider | Mar 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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