Aimee Jean Gustafson, D.D.S.
NPI 1205148145ActiveIndividual· Dentist· Polson, MT
Dentist (D.D.S.) in Polson, Montana, licensed in MT and MN, with an NPI issued in July 2010. Enrolled in Medicare as order and referring only - oral surgery.
Overview
| NPI | 1205148145 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.D.S. |
| Sole proprietor | No |
| NPI issued | Jul 8, 2010 |
| Last updated in NPPES | Mar 15, 2024 |
| Certified by provider | Mar 15, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | DEN-DEN-LIC-2485 | MT |
| Dentist, General Practice | 1223G0001X | 2485 | MT |
| Dentist | 122300000X | D12841 | MN |
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) | Enrolled Order and Referring Only - Oral Surgery (MT) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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