Active NPI
Walter John Babula, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fairbanks, AK
National Provider Identifier
1003170291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 9
- Practice address
- 1919 Lathrop St Ste 102
Fairbanks, AK 99701-5937 - Phone
- (907) 452-2939
- Fax
- (907) 451-7330
- NPI assigned
- Jul 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 330 | AK | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 9 | AK | Primary |
Addresses
Primary practice location
1919 Lathrop St Ste 102
Fairbanks, AK 99701-5937
Mailing address
1919 Lathrop St Ste 102
Fairbanks, AK 99701-5937
Phone (907) 452-2939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330 | AK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairbanks Orthodontic Group a Prof Corp | Dentist | Past | Accepting new patients |
| Fairbanks Orthodontic Group, a Professional Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fairbanks, AK
- NPI 1013084680
-
- Dental Clinic/Center
- Fairbanks, AK
- NPI 1376982918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341187200000",
"number": "1003170291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 LATHROP ST STE 102",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015937",
"telephone_number": "907-452-2939",
"fax_number": "907-451-7330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 LATHROP ST STE 102",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015937",
"telephone_number": "907-452-2939",
"fax_number": "907-451-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BABULA",
"first_name": "WALTER",
"middle_name": "JOHN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-02",
"last_updated": "2012-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "330",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "AK",
"license": "9",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.