Maple Grove Periodontics and Implant Dentistry
NPI 1891295861ActiveOrganization· Dentist, Periodontics· Maple Grove, MN
Dentist, Periodontics in Maple Grove, Minnesota, registered in NPPES in February 2018. The authorized official on file is Jennifer C. Sullivan, DDS, MSD, Periodontist/Owner.
Overview
| NPI | 1891295861 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 16, 2018 |
| Last updated in NPPES | Feb 16, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | S125 | 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 |
|---|
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