Jonathan Oudin, DDS, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JONATHAN OUDIN, DDS, LLC

Practice address

1700 E Bogard Rd Ste A201
Wasilla, AK 99654-6569

Phone

(907) 373-8455

Fax

(907) 373-8456

NPI assigned

Jul 20, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Oudin, DDSNPI 1427337732

Title

Owner

Phone

(214) 317-0521

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alaska Center for Dentistry Doing business as

Locations

Practitioners 1

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

• Jonathan Robert Oudin, D.D.S.

  • General Practice Dentistry
  • Wasilla, AK
  • NPI 1427337732
  NPD Authorized official

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1265167522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD STE A201",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546569",
            "telephone_number": "907-373-8455",
            "fax_number": "907-373-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD STE A201",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546569",
            "telephone_number": "907-373-8455",
            "fax_number": "907-373-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN OUDIN, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "OUDIN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-317-0521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1574946",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaska Center for Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachael Johnson
• Alice Renee Johnston, PTA
• Jennifer Johnston
• Tanya Lynn Johnston
• Jonathan F Ramirez DC LLC
• Breanna Jones
• Caitlin Anne Jones
• Colton Alan Jones
• Cynthia Gay Jones, ANP
• Elisabeth Manet Jones

• General Practice Dentistry in Wasilla, AK
• Providers in Wasilla, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.