Divine Dental LLC
NPI 1710299268ActiveOrganization· Dentist, General Practice· Baltimore, MD
Dentist, General Practice in Baltimore, Maryland, registered in NPPES in July 2010, part of Divine Dental LLC. The authorized official on file is Maryellen Desrochers, Office Manager.
Overview
| NPI | 1710299268 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Divine Dental LLC |
| NPI issued | Jul 12, 2010 |
| Last updated in NPPES | Nov 14, 2023 |
| Certified by provider | Nov 14, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 7069 | MD |
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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