Alaska Dental Outreach Consortium

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ALASKA DENTAL OUTREACH CONSORTIUM

Practice address

9170 Jewel Lake Rd Ste 203
Anchorage, AK 99502-5390

Phone

(907) 563-3011

Fax

(907) 563-3009

NPI assigned

Oct 20, 2009

Organization subpart

No

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

Authorized official

Name

Mr. James Richard Towle

Title

Secretary of the Board of Directors

Phone

(907) 563-3011

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1356677751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9170 JEWEL LAKE RD STE 203",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995025390",
            "telephone_number": "907-563-3011",
            "fax_number": "907-563-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9170 JEWEL LAKE RD STE 203",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995025390",
            "telephone_number": "907-563-3011",
            "fax_number": "907-563-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA DENTAL OUTREACH CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "TOWLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "SECRETARY OF THE BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "907-563-3011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaska Day Habilitation Services LLC
• Alaska Dental Care, LLC
• Alaska Dental Care, LLC.
• Alaska Dental Center
• Alaska Dental Group P.C.
• Alaska Dentistry for Kids, LLC
• Alaska Dialysis - Laurel Street, LLC
• Alaska Digestive and Liver Disease, LLC
• Alaska Digestive Center, LLC
• Alaska Dinner Factory, Inc.

• All providers in Anchorage, AK
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.