Individual
DR. JOHN JOSEPH ILLUMINATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 COLLEGE ST, PORTLAND, ME 04103-2617
(207) 221-4747
Mailing address
219 BLUFF RD, YARMOUTH, ME 04096-7305
(207) 831-2155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2953
ME
1223G0001X
General Practice Dentistry
Primary
DEN2953
ME
Other
Enumeration date
02/01/2008
Last updated
07/01/2026
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