Kenneth B Weddell PLLC
NPI 1073862819ActiveOrganization· Dentist, General Practice· Bloomington, MN
Dentist, General Practice in Bloomington, Minnesota, registered in NPPES in September 2012. The authorized official on file is Kenneth Bruce Weddell, DDS, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1073862819 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 7, 2012 |
| Last updated in NPPES | Aug 9, 2023 |
| Certified by provider | Aug 9, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | D12619 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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