Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maple Grove Periodontics and Implant Dentistry

Organization Periodontics · NPI 1891295861

Maple Grove Periodontics and Implant Dentistry is a Periodontics in Maple Grove, Minnesota. Licensed in Minnesota. Registered with an NPI since 2018.

Licensed in
MN
In the registry since
2018

Practice location Address checks out

12000 Elm Creek Blvd N
Maple Grove, MN 55369-7073
Phone: (763) 420-0200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence S125 (MN)

Record details

NPI number1891295861
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Sullivan — Periodontist/Owner · (646) 808-9088
NPI enumeratedFebruary 16, 2018
Last updated in NPPESFebruary 16, 2018
Mailing address12000 Elm Creek Blvd N, Maple Grove, MN 55369-7073

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