South Gate Cosmetic & Implant Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SOUTH GATE COSMETIC & IMPLANT DENTISTRY LLC

Practice address

12570 Old Seward Hwy Ste 201
Anchorage, AK 99515-3532

Phone

(907) 349-6466

Fax

(907) 260-3459

NPI assigned

Feb 19, 2019

Last updated

Feb 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry CHI Hu, DDSNPI 1619088168

Title

Ceo/President

Phone

(907) 349-6466

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry CHI Hu, DDS

  • Dentist
  • Soldotna, AK
  • NPI 1619088168
  NPD Authorized official

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1194281725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697521",
            "telephone_number": "907-262-6466",
            "fax_number": "907-260-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12570 OLD SEWARD HWY STE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153532",
            "telephone_number": "907-349-6466",
            "fax_number": "907-260-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GATE COSMETIC & IMPLANT DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "HU",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "CHI",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "907-349-6466",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Anchorage Dental Clinic LLC
• South Anchorage Family Dentistry LLC (True North Family Dental)
• South Anchorage Physical Therapy Inc
• South Anchorage Speech Solutions, LLC
• South Anchorage Surgery Center, LLC
• South Sound Inpatient Physicians, PLLC
• Sierra Southam, CTRS
• Brittin Timothy Southard, DO
• Mendy Ann Southard, DO
• Southcentral Foundation

• Dentist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.