Willow Tree Dental Group LLC
NPI 1093974446ActiveOrganization· Dentist, Periodontics· Meridian, ID
Dentist, Periodontics in Meridian, Idaho, registered in NPPES in June 2008, part of Willow Tree Dental Group LLC. The authorized official on file is Shannon Love, Financial Manager.
Overview
| NPI | 1093974446 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Willow Tree Dental Group LLC |
| NPI issued | Jun 2, 2008 |
| Last updated in NPPES | Jun 2, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | D3443 | ID |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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