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MRS. MAUREEN O'SULLIVAN ADT
NPI 1619435682
Advanced Practice Dental Therapist in Roseville, MN

Active since March 07, 2019
385 S OWASSO BLVD W, ROSEVILLE, MN 55113(612) 801-5203 Get Directions Write a Review

NPPES record last updated: June 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 19, 2020, Mar 7, 2019 (2 updates tracked since 2019).

About Mrs. Maureen O'sullivan Adt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MAUREEN O'SULLIVAN ADT (NPI 1619435682) is an individual advanced practice dental therapist in Roseville, Minnesota, licensed in Minnesota (DT83) and active in the NPI registry since March 2019.

NPPES Registry Identity

NPI1619435682
Entity TypeIndividualFemale
Primary Taxonomy125K00000X
Provider Legal NameMRS. MAUREEN O'SULLIVANCredential: ADT
Location Address385 S OWASSO BLVD WRoseville, MN 55113-2119
Mailing Address385 S Owasso Blvd WRoseville, MN 55113-2119 · (612) 801-5203
Phone(612) 801-5203
Sole ProprietorYes
Enumeration DateMarch 7, 2019
Last NPPES UpdateJune 19, 20202 updates tracked since enumeration
NPPES CertifiedJune 19, 2020
✔ NPI 1619435682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAdvanced Practice Dental TherapistDental Providers
Taxonomy Code125K00000X
License✔ Licensed in MN · DT83
Definition
An Advanced Practice Dental Therapist is:
(1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or
(2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum.

The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations.
Also ListedDental HygienistTaxonomy 124Q00000X · License H9759 (MN)
385 S OWASSO BLVD W, Roseville, MN 55113
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PUBLIC HEALTH DENTAL LLC
Clinic/Center (Dental)
385 S OWASSO BLVD W
ROSEVILLE, MN 55113
Ramsey County (612) 801-5203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maureen O'sullivan's NPI number?

The NPI number for Maureen O'sullivan is 1619435682. It was assigned to this individual provider in the NPPES registry on March 7, 2019.

Where is Maureen O'sullivan located?

Maureen O'sullivan practices at 385 S Owasso Blvd W, Roseville, MN 55113. The listed phone number is (612) 801-5203.

What is Maureen O'sullivan's specialty?

The primary specialty registered for this NPI is Advanced Practice Dental Therapist with taxonomy code 125K00000X.

When was this NPI record last updated?

The NPPES record for Maureen O'sullivan was last updated on June 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.