Individual provider Active NPI

Kendall B Skinner, DMD

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1033366760
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1134 Issued in AK
Practice address
1000 Omalley Rd Ste 101
Anchorage, AK 99515-3083
Phone
(907) 349-0022
NPI assigned
Aug 25, 2008
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10691 CO
General Practice Dentistry 1223G0001X 1134 AK Primary

Addresses

Primary practice location

1000 Omalley Rd Ste 101
Anchorage, AK 99515-3083

Mailing address

1000 Omalley Rd Ste 101
Anchorage, AK 99515-3083
Phone (907) 349-0022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1134AKMDGeneral Practice Dentistry
10691COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Excellence, LLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

1000 Omalley Rd
Ste 101
Anchorage, AK 99515
Phone (907) 349-0022

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1033366760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OMALLEY RD STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153083",
            "telephone_number": "907-349-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OMALLEY RD STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153083",
            "telephone_number": "907-349-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "KENDALL",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10691",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.