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Portage Pediatric Dentistry PLC

NPI 1366817827ActiveOrganization· Dentist, Pediatric Dentistry· Portage, MI

Dentist, Pediatric Dentistry in Portage, Michigan, registered in NPPES in December 2015. The authorized official on file is Jody L. Wrathall, DDS, MS, Owner.

Overview

NPI1366817827
StatusActive
Entity typeOrganization
NPI issuedDec 9, 2015
Last updated in NPPESDec 9, 2015

Specialties and licenses

TaxonomyCodeLicenseState
Dentist, Pediatric Dentistry Primary1223P0221X2901020339MI
Dentist, Pediatric Dentistry1223P0221X2901009877MI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 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 pediatric dentists in Portage

All pediatric dentists in Michigan