Individual provider Active NPI

Gina Torres, DDS

  • Dentist
  • Ft Wainwright, AK
National Provider Identifier
1043477284
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12338 Issued in MN
Practice address
4076 Neely Rd
Ft Wainwright, AK 99703
Phone
(907) 750-2955
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12338 MN Primary
General Practice Dentistry 1223G0001X D12338 MN

Addresses

Primary practice location

4076 Neely Rd
Ft Wainwright, AK 99703

Mailing address

4076 Neely Road
BLDG 4076, Room 1B-201
Fort Wainwright, AK 99703
Phone (907) 361-6028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160303000525 MN Order and Referring Only - DentistPractitioner - Dentist 5799081659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1043477284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "address_2": "BLDG 4076, ROOM 1B-201",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-6028",
            "fax_number": "907-361-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY RD",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-750-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "GINA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12338",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Wainwright, AK

Sources for this page

Verify at the official NPI Registry.