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Modern Dental Professionals Mn PC

NPI 1215307061ActiveOrganization· Dentist, General Practice· Big Lake, MN

Dentist, General Practice in Big Lake, Minnesota, registered in NPPES in October 2015. The authorized official on file is Jeffrey Moos, DDS, Owner.

Overview

NPI1215307061
StatusActive
Entity typeOrganization
NPI issuedOct 5, 2015
Last updated in NPPESOct 5, 2015

Specialties and licenses

TaxonomyCodeLicenseState
Dentist, General Practice Primary1223G0001X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Dentist, General Practice providers in Big Lake

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