Modern Periodontics
NPI 1679855761ActiveOrganization· Dentist, Periodontics· Grand Rapids, MI
Dentist, Periodontics in Grand Rapids, Michigan, registered in NPPES in September 2011. The authorized official on file is Erin Nicole Moerdyke, Office Manager.
Overview
| NPI | 1679855761 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 14, 2011 |
| Last updated in NPPES | Sep 14, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | 16791 | MI |
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 |
|---|
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