Individual provider Active NPI

Susan Ann Sergie, D.M.D.

  • Dentist
  • Anchorage, AK
National Provider Identifier
1124466552
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEND1500 Issued in AK
Practice address
2020 Abbott Rd Ste 1
Anchorage, AK 99507-4624
Phone
(907) 344-2483
Fax
(907) 349-2489
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEND1500 AK Primary

Addresses

Primary practice location

2020 Abbott Rd Ste 1
Anchorage, AK 99507-4624

Mailing address

2020 Abbott Rd Ste 1
Anchorage, AK 99507-4624
Phone (907) 344-2483

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEND1500AKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Family Dentistry CurrentSince Mar 5, 2023 Accepting new patients
The Bishop Dental Group Inc PastSince Jan 15, 2023 Accepting new patients

Locations

2020 Abbott Rd
Ste 1
Anchorage, AK 99507
Phone (907) 344-2483

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1124466552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 ABBOTT RD STE 1",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074624",
            "telephone_number": "907-344-2483",
            "fax_number": "907-349-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 ABBOTT RD STE 1",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074624",
            "telephone_number": "907-344-2483",
            "fax_number": "907-349-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGIE",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "DEND1500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.