Mangrum Dental Corporation
NPI 1275776684ActiveOrganization· Dentist, General Practice· Petaluma, CA
Dentist, General Practice in Petaluma, California, registered in NPPES in April 2009. The authorized official on file is Debra A. Quackenbush, Office Manager.
Overview
| NPI | 1275776684 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 15, 2009 |
| Last updated in NPPES | Apr 15, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 44612 | CA |
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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