Arctic Oral Surgery, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ARCTIC ORAL SURGERY, LLC

Practice address

12641 Old Glenn Hwy Ste 103
Eagle River, AK 99577

Phone

(907) 726-5600

Fax

(907) 726-5602

NPI assigned

Feb 16, 2018

Last updated

Jul 26, 2018By 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

Leonardo Manuel Rios-Andersen, DMDNPI 1699735050

Title

Oral Surgeon

Phone

(907) 726-5600

Specialties & licenses 1

Addresses

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.

• Leonardo Manuel Rios-Andersen, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Eagle River, AK
  • NPI 1699735050
  Authorized official Same address or phone

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532563200000",
    "number": "1215437165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12641 OLD GLENN HWY STE 103",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777040",
            "telephone_number": "907-726-5600",
            "fax_number": "907-726-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12641 OLD GLENN HWY STE 103",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "99577",
            "telephone_number": "907-726-5600",
            "fax_number": "907-726-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCTIC ORAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-07-26",
        "status": "A",
        "authorized_official_last_name": "RIOS-ANDERSEN",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "907-726-5600",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.