Maureen O'Sullivan, ADT

Primary specialty

Advanced Practice Dental TherapistTaxonomy code 125K00000X

License

DT83 Issued in MN

Practice address

385 S Owasso Blvd W
Roseville, MN 55113-2119

Phone

(612) 801-5203

NPI assigned

Mar 7, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Public Health Dental LLC

  • Dental Clinic/Center
  • Roseville, MN
  • NPI 1770213639
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1619435682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 S OWASSO BLVD W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132119",
            "telephone_number": "612-801-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 S OWASSO BLVD W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132119",
            "telephone_number": "612-801-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "ADT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H9759",
            "primary": false
        },
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "MN",
            "license": "DT83",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley O'Connell, LPN
• Megan Jo O'Leary
• Ryan Blair O'Malley
• Sarah Maria O'Neil
• Brendan M O'Shea, MD
• Brianne Oachs
• Monica Oberg, MSW, LICSW
• Octave Behavioral Michigan PC
• Kathleen C Odin, PTA
• Maureen A. Ohland, DDS

• Advanced Practice Dental Therapist in Roseville, MN
• Providers in Roseville, MN by specialty
• Advanced Practice Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.