John P Bast, D.D.S
Individual provider Active NPI General Practice Dentistry · Fairbanks, AK
NPI 1124037478 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124037478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 262180 (AK)
- Practice address
- 570 University Ave
Fairbanks, AK 99709-3641 - Phone
- (907) 479-2206
- Fax
- (907) 479-6847
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 262180 | AK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Dental Center | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 262180 | AK | Yes |
Addresses
Primary practice location
570 University Ave
Fairbanks, AK 99709-3641
Mailing address
570 University Ave
Fairbanks, AK 99709-3641
Phone (907) 479-2206
Other providers in Fairbanks, AK
- Sharee Bartley
- Kristen Nicole Barton
- Angela M Bass
- John Browning Bass
- Fred D Bast
- Kelly Catherine Bast
- Celina Batchelder
- Brianna Bates
- David B Bates
- Sha-Raya Lynn Bates
All providers in Fairbanks, AK · General Practice Dentistry in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.