Individual provider Active NPI

Morrie O Talbot, DDS

  • Dentist
  • Unalaska, AK
National Provider Identifier
1164549325
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104064 Issued in AK
Practice address
1 Gilman Way
#201
Unalaska, AK 99685
Phone
(907) 581-3828
NPI assigned
Mar 23, 2007
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 359751-9922 UT
Dentist 122300000X 104064 AK Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161230001496 UT Order and Referring Only - DentistPractitioner - Dentist 0941581169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104064AKMDDentist
359751-9922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hollt LLC PastSince Jun 12, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1164549325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 S 3150 W",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840788739",
            "telephone_number": "480-789-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GILMAN WAY",
            "address_2": "#201",
            "city": "UNALASKA",
            "state": "AK",
            "postal_code": "99685",
            "telephone_number": "907-581-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOT",
        "first_name": "MORRIE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-06-10",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "359751-9922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "104064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Unalaska, AK

Sources for this page

Verify at the official NPI Registry.