31 Elmgrove Dental LLC
NPI 1225787708ActiveOrganization· Dentist, General Practice· Providence, RI
Dentist, General Practice in Providence, Rhode Island, registered in NPPES in March 2022. The authorized official on file is Jessica A. Polak, CDA, Office Manager.
Overview
| NPI | 1225787708 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 22, 2022 |
| Last updated in NPPES | Mar 22, 2022 |
| Certified by provider | Mar 8, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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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