Active NPI
Marlo Leslie Saenz, D.D.S.
- Dentist
- Fairbanks, AK
National Provider Identifier
1255476917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1195
- Practice address
- 122 1St Ave
Suite 600
Fairbanks, AK 99701-4803 - Phone
- (907) 452-8251
- NPI assigned
- Feb 20, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1195 | AK | Primary |
Addresses
Primary practice location
122 1St Ave
Suite 600
Fairbanks, AK 99701-4803
Mailing address
2500 Allen Adale Rd
Fairbanks, AK 99709-2580
Phone (907) 452-7299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD1303 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1195 | AK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255476917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 ALLEN ADALE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997092580",
"telephone_number": "907-452-7299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 1ST AVE",
"address_2": "SUITE 600",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014803",
"telephone_number": "907-452-8251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAENZ",
"first_name": "MARLO",
"middle_name": "LESLIE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DD1303",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.