Organization Active NPI

The Delta Dentist, PC

  • Dental Clinic/Center
  • Delta Junction, AK
National Provider Identifier
1053712588
Registry record updated Jul 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
815 Issued in AK
Legal business name
THE DELTA DENTIST, PC
Practice address
266 Richardson Hwy
Delta Junction, AK 99737-9800
Phone
(907) 895-2200
NPI assigned
Sep 16, 2014
Last updated
Jul 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2016

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

Authorized official

Name
Dr. Bradley Oliver, DMD
Title
Owner
Phone
(907) 895-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 815 AK Primary

Addresses

Primary practice location

266 Richardson Hwy
Delta Junction, AK 99737-9800

Mailing address

PO Box 1269
Delta Junction, AK 99737-1269
Phone (907) 895-2200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467590400000",
    "number": "1053712588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1269",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "997371269",
            "telephone_number": "907-895-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 RICHARDSON HWY",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "997379800",
            "telephone_number": "907-895-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DELTA DENTIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2016-07-04",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-895-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AK",
            "license": "815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delta Junction, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2016; 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.