Morrie O Talbot, DDS
Individual provider Active NPI Dentist · Unalaska, AK
NPI 1164549325 · NPPES record last updated Jun 10, 2022
Key facts
- NPI
- 1164549325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 104064 (AK)
- Practice address
- 1 Gilman Way
#201
Unalaska, AK 99685 - Phone
- (907) 581-3828
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161230001496 | UT | Order and Referring Only - Dentist |
0941581169 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104064 | AK | MD | Dentist |
| 359751-9922 | UT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 359751-9922 | UT | |
| Dentist | 122300000X | 104064 | AK | Yes |
Addresses
Primary practice location
1 Gilman Way
#201
Unalaska, AK 99685
Mailing address
1565 S 3150 W
Vernal, UT 84078-8739
Phone (480) 789-2070
Other providers in Unalaska, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.