Same Day Dental Palmer L.L.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

628 Issued in AK

Legal business name

SAME DAY DENTAL PALMER L.L.C.

Doing business as

Same Day Dental Palmer

Practice address

125 W Evergreen Ave
Palmer, AK 99645-6908

Phone

(616) 902-4077

Fax

(888) 341-5659

NPI assigned

Dec 8, 2017

Last updated

Jun 11, 2019By 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

Charles F Cole, DMD

Title

Dentist/Owner

Phone

(907) 631-3630

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Same Day Dental Palmer Doing business as

Locations

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1114432473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W EVERGREEN AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456908",
            "telephone_number": "616-902-4077",
            "fax_number": "888-341-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W EVERGREEN AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456908",
            "telephone_number": "616-902-4077",
            "fax_number": "888-341-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAME DAY DENTAL PALMER L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "907-631-3630",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AK",
            "license": "628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1597353",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Same Day Dental Palmer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Palmer, AK
• Providers in Palmer, AK by specialty
• Dental Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.