Breakwater Oral and Maxillofacial Surgery PLLC
NPI 1114856226ActiveOrganization· Dentist, Periodontics· Rochester, MI
Dentist, Periodontics in Rochester, Michigan, registered in NPPES in May 2026, part of Breakwater Oral and Maxillofacial Surgery PLLC. The authorized official on file is Jenn Heritage, Credentialing Manager.
Overview
| NPI | 1114856226 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Breakwater Oral and Maxillofacial Surgery PLLC |
| NPI issued | May 15, 2026 |
| Last updated in NPPES | Jun 15, 2026 |
| Certified by provider | Jun 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | — | — |
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 |
|---|