Southern Minnesota Periodontics, PA
NPI 1609012624ActiveOrganization· Dentist, Periodontics· Mankato, MN
Dentist, Periodontics in Mankato, Minnesota, registered in NPPES in December 2008. The authorized official on file is Gary Jernberg, Owner.
Overview
| NPI | 1609012624 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 22, 2008 |
| Last updated in NPPES | Dec 22, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | 8671 | MN |
| Dentist, Periodontics | 1223P0300X | 11710 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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 |
|---|
Other periodontists in Mankato
- 1316390669
- 1851510952
- 1164420675