Active NPI
Kimlea Sara Medlin, DDS
- Dentist
- Barrow, AK
National Provider Identifier
1154408722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1217
- Practice address
- 1296 Agvik St
Barrow, AK 99723 - Phone
- (907) 852-9221
- Fax
- (907) 852-9297
- NPI assigned
- Nov 1, 2006
- Last updated
- Jun 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9244 | CO | |
| Dentist | 122300000X | 1217 | AK | Primary |
Addresses
Primary practice location
1296 Agvik St
Barrow, AK 99723
Mailing address
1296 Agvik St
PO Box 29
Barrow, AK 99723
Phone (907) 852-9221
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1217 | AK | MD | Dentist |
| 9244 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214179200000",
"number": "1154408722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1296 AGVIK ST",
"address_2": "PO BOX 29",
"city": "BARROW",
"state": "AK",
"postal_code": "99723",
"telephone_number": "907-852-9221",
"fax_number": "907-852-9297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1296 AGVIK ST",
"city": "BARROW",
"state": "AK",
"postal_code": "99723",
"telephone_number": "907-852-9221",
"fax_number": "907-852-9297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDLIN",
"first_name": "KIMLEA",
"middle_name": "SARA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2008-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "9244",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barrow, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.