NPIMap

Organization Active NPI

Summit Dental Lab, Inc

  • Dental Laboratory
  • Eagle River, AK
National Provider Identifier
1235760893
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
Legal business name
SUMMIT DENTAL LAB, INC
Practice address
13015 Old Glenn Hwy Ste 150
Eagle River, AK 99577-7562
Phone
(907) 696-5227
NPI assigned
Jan 31, 2020
Last updated
Jan 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Authorized official

Name
Michael Sanders, DMDNPI 1538387790
Title
Owner
Phone
(907) 694-8234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory 292200000X NU Primary

Addresses

Primary practice location

13015 Old Glenn Hwy Ste 150
Eagle River, AK 99577-7562

Mailing address

13015 Old Glenn Hwy Ste 150
Eagle River, AK 99577-7562
Phone (907) 696-5227

National Provider Directory

National Provider Directory

Locations

13015 Old Glenn Hwy
Ste 150
Eagle River, AK 99577
Phone (907) 696-5227

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580428800000",
    "number": "1235760893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13015 OLD GLENN HWY STE 150",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777562",
            "telephone_number": "907-696-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13015 OLD GLENN HWY STE 150",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777562",
            "telephone_number": "907-696-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL LAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-694-8234",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.