MAPLE GROVE PERIODONTICS AND IMPLANT DENTISTRY
NPI 1891295861
Dentist - Periodontics in Maple Grove, MN

Active since February 16, 2018
12000 ELM CREEK BLVD N, MAPLE GROVE, MN 55369(763) 420-0200 Get Directions Write a Review

NPPES record last updated: February 16, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Maple Grove Periodontics And Implant Dentistry NPPES

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

MAPLE GROVE PERIODONTICS AND IMPLANT DENTISTRY (NPI 1891295861) is a healthcare organization registered as a periodontics in Maple Grove, Minnesota and active in the NPI registry since February 2018. The organization lists Jennifer C Sullivan, Periodontist/owner, as its authorized official.

NPPES Registry Identity

NPI1891295861
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameMAPLE GROVE PERIODONTICS AND IMPLANT DENTISTRY
Location Address12000 ELM CREEK BLVD NMaple Grove, MN 55369-7073
Mailing Address12000 Elm Creek Blvd NMaple Grove, MN 55369-7073 · (646) 808-9088
Organization SubpartNo
Authorized OfficialJennifer C SullivanPeriodontist/owner · (646) 808-9088
Enumeration DateFebruary 16, 2018
NPI 1891295861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License Licensed in MN · S125
Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

12000 ELM CREEK BLVD N, Maple Grove, MN 55369

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

Contractor
12000 ELM CREEK BLVD N, SUITE L70
MAPLE GROVE, MN 55369
Chiropractor
12000 ELM CREEK BLVD N
MAPLE GROVE, MN 55369
Family Medicine
12000 ELM CREEK BLVD N
MAPLE GROVE, MN 55369
Physician Assistant
12000 ELM CREEK BLVD N
MAPLE GROVE, MN 55369
Nurse Practitioner (Occupational Health)
12000 ELM CREEK BLVD N, #140
MAPLE GROVE, MN 55369
Clinic/Center (Dental)
12000 ELM CREEK BLVD N, SUITE 230
MAPLE GROVE, MN 55369
Dentist (General Practice)
12000 ELM CREEK BLVD N, SUITE 230
MAPLE GROVE, MN 55369
Specialist/Technologist (Athletic Trainer)
12000 ELM CREEK BLVD N, #120
MAPLE GROVE, MN 55369

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 Maple Grove Periodontics And Implant Dentistry's NPI number?

The NPI number for Maple Grove Periodontics And Implant Dentistry is 1891295861. It was assigned to this organization in the NPPES registry on February 16, 2018.

Where is Maple Grove Periodontics And Implant Dentistry located?

Maple Grove Periodontics And Implant Dentistry is located at 12000 Elm Creek Blvd N, Maple Grove, MN 55369. The listed phone number is (763) 420-0200.

What is Maple Grove Periodontics And Implant Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Maple Grove Periodontics And Implant Dentistry was last updated on February 16, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.