Park Boulevard Family Dentistry
NPI 1578170684ActiveOrganization· Dentist· Pinellas Park, FL
Dentist in Pinellas Park, Florida, registered in NPPES in September 2020. The authorized official on file is Brianne Leigh Wade, DMD, Owner/President/Dentist.
Overview
| NPI | 1578170684 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 24, 2020 |
| Last updated in NPPES | Sep 24, 2020 |
| Certified by provider | Sep 23, 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 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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