Dental Workshop Partnership

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL WORKSHOP PARTNERSHIP

Practice address

190 Kevins Way
North Pole, AK 99705

Phone

(907) 490-4650

Fax

(907) 490-4653

NPI assigned

Aug 27, 2014

Organization subpart

No

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

Authorized official

Name

Jeremy Bauer, DDS

Title

Dentist

Phone

(907) 490-4650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Alaska Dental Arts North Pole Doing business as
• Jeremy Bauer DDS LLC Former legal business name

Locations

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1346640331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 KEVINS WAY",
            "city": "NORTH POLE",
            "state": "AK",
            "postal_code": "99705",
            "telephone_number": "907-490-4650",
            "fax_number": "907-490-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 KEVINS WAY",
            "city": "NORTH POLE",
            "state": "AK",
            "postal_code": "99705",
            "telephone_number": "907-490-4650",
            "fax_number": "907-490-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL WORKSHOP PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "907-490-4650",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1580510",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaska Dental Arts North Pole",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jeremy Bauer DDS LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Elizabeth D Cleveland
• Kalee Craft
• Carol Tracy Cyr, RN
• Mari Ann Davis, MSHF, BSBA,PDMT, LMT
• Elizabeth Anne Delp
• Cheryl L Denton
• Eileen Michelle Dinger
• Eagles Wings LLC
• Tamela Eleasia Edwards, MA, CMHC, NCC, LPC
• William L Emery, LPC

• All providers in North Pole, AK
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.