Alaska Dental Care, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

875 Issued in AK

Legal business name

ALASKA DENTAL CARE, LLC

Practice address

4000 Old Seward Hwy
Suite 200
Anchorage, AK 99503-6068

Phone

(907) 561-3639

Fax

(907) 562-5337

NPI assigned

Jan 13, 2015

Last updated

Jan 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brett M GardinerNPI 1912122821

Title

Owner Dentist

Phone

(907) 561-3639

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brett M Gardiner, DDS

  • General Practice Dentistry
  • Anchorage, AK
  • NPI 1912122821
  NPD (past) Authorized official
• Kelly Mopangga Allen, DMD

  • General Practice Dentistry
  • Anchorage, AK
  • NPI 1356124564
  NPD (past)
• Kevin Jared Parks, DDS

  • General Practice Dentistry
  • Wasilla, AK
  • NPI 1124381363
  NPD (past)

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1033508122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLD SEWARD HWY",
            "address_2": "SUITE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995036068",
            "telephone_number": "907-561-3639",
            "fax_number": "907-562-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLD SEWARD HWY",
            "address_2": "SUITE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995036068",
            "telephone_number": "907-561-3639",
            "fax_number": "907-562-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "GARDINER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "907-561-3639",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003211",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alaska Consumer Direct Personal Care, LLC (Consumer Direct Care Network Alaska)
• Alaska Counseling Services LLC
• Alaska CVS Pharmacy LLC (CVS Pharmacy #17436)
• Alaska CVS Pharmacy LLC (C VS Pharmacy #17435)
• Alaska Day Habilitation Services LLC
• Alaska Dental Care, LLC.
• Alaska Dental Center
• Alaska Dental Group P.C.
• Alaska Dental Outreach Consortium
• Alaska Dentistry for Kids, LLC

• Dentist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.