Evergreen Dental, LLC
NPI 1518574052ActiveOrganization· Dentist· Palmer, AK
Dentist in Palmer, Alaska, registered in NPPES in September 2020. The authorized official on file is Rachael Fetuao Middleton, Chief Operations Officer.
Overview
| NPI | 1518574052 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 29, 2020 |
| Last updated in NPPES | Sep 29, 2020 |
| Certified by provider | Sep 29, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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