Bubble Gum Kids Dentistry
NPI 1790461630ActiveOrganization· Dentist, Pediatric Dentistry· Southgate, MI
Dentist, Pediatric Dentistry in Southgate, Michigan, registered in NPPES in June 2023. The authorized official on file is Amy Paundlay, Sr. Vice President Of Operatopms.
Overview
| NPI | 1790461630 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 26, 2023 |
| Last updated in NPPES | Jun 26, 2023 |
| Certified by provider | Jun 26, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | — | — |
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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