Individual provider Active NPI

Courtney Schwartz, DDS

  • General Practice Dentistry
  • Eagle River, AK
National Provider Identifier
1063760593
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
117330 Issued in AK
Practice address
17101 Snowmobile LN Ste 107
Eagle River, AK 99577-7043
Phone
(907) 622-6233
NPI assigned
Aug 15, 2012
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8342588-9921 UT
General Practice Dentistry 1223G0001X 117330 AK Primary

Addresses

Primary practice location

17101 Snowmobile LN Ste 107
Eagle River, AK 99577-7043

Mailing address

17101 Snowmobile LN Ste 107
Eagle River, AK 99577-7043
Phone (907) 622-6233

Other practice location 1

5955 Zeamer Ave
Jber, AK 99506-3702
Phone (907) 580-5010

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
117330AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alpenglow Dental Group LLC General Practice CurrentSince Jan 21, 2024 Accepting new patients
Allen Dental Group LLC PastSince Jul 24, 2022 Accepting new patients

Locations

17101 Snowmobile Ln
Ste 107
Eagle River, AK 99577
Phone (907) 622-6233

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, 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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1063760593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN STE 107",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777043",
            "telephone_number": "907-622-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN STE 107",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777043",
            "telephone_number": "907-622-6233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Zeamer Ave",
            "address_purpose": "LOCATION",
            "city": "Jber",
            "state": "AK",
            "postal_code": "995063702",
            "country_code": "US",
            "telephone_number": "907-580-5010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "8342588-9921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "117330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.