NPIMap

Organization Active NPI

Kodiak Area Native Association

  • Dental Clinic/Center
  • Kodiak, AK
National Provider Identifier
1093213167
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KODIAK AREA NATIVE ASSOCIATION
Practice address
1317 Mill Bay Rd
Kodiak, AK 99615-6411
Phone
(907) 486-3291
Fax
(907) 486-9896
NPI assigned
Jan 24, 2018
Organization subpart
Yes
Parent organization
KODIAK AREA NATIVE ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Authorized official

Name
Michael Pfeffer
Title
Chief Operating Officer
Phone
(907) 486-9800

Specialties & licenses 1

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

Addresses

Primary practice location

1317 Mill Bay Rd
Kodiak, AK 99615-6411

Mailing address

3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone (907) 486-9880

Other names 1

  • Family Dentistry of Kodiak Other name

National Provider Directory

National Provider Directory
Tax ID family
Kodiak Area Native Assn5 organizations share this tax ID, including this one
Part of
Kodiak Area Native Assn

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/kodiakhealthcare/r4/

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1093213167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952",
            "telephone_number": "907-486-9880",
            "fax_number": "907-486-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 MILL BAY RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156411",
            "telephone_number": "907-486-3291",
            "fax_number": "907-486-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODIAK AREA NATIVE ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KODIAK AREA NATIVE ASSOCIATION",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "PFEFFER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "907-486-9800"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry of Kodiak",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kodiak, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.