Alaska Dental Group P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

436733 Issued in AK

Legal business name

ALASKA DENTAL GROUP P.C.

Practice address

3340 Providence Dr Ste 560
Providence Medical Office BLDG.
Anchorage, AK 99508-4643

Phone

(907) 562-6648

Fax

(907) 561-8385

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark James McLean, D.M.D.NPI 1346390580

Title

Owner

Phone

(907) 562-6648

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mark J McLean DMD MS PC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark James McLean, DMD

  • General Practice Dentistry
  • Anchorage, AK
  • NPI 1346390580

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194875393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR STE 560",
            "address_2": "PROVIDENCE MEDICAL OFFICE BLDG.",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084643",
            "telephone_number": "907-562-6648",
            "fax_number": "907-561-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR STE 560",
            "address_2": "PROVIDENCE MEDICAL OFFICE BLDG.",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084643",
            "telephone_number": "907-562-6648",
            "fax_number": "907-561-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA DENTAL GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCLEAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-562-6648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "436733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "826322",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0888",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark J McLean DMD MS PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Anchorage, AK
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.