TC Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

TC PEDIATRIC DENTISTRY LLC

Doing business as

Southeast Pediatric Dentistry

Practice address

21 Jefferson Way Ste 102a
Ketchikan, AK 99901-5951

Phone

(907) 220-9231

NPI assigned

Mar 24, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Brett Christensen, DMDNPI 1073627295

Title

Owner/Doctor

Phone

(435) 669-9051

Specialties & licenses 1

Addresses

Other names 1

• Southeast Pediatric Dentistry Doing business as

Practitioners 2

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

• Brett Kendall Christensen, DMD

  • Dentist
  • St George, UT
  • NPI 1073627295
  NPD Authorized official
• Tyler Max Torres, DDS

  • Pediatric Dentistry
  • St George, UT
  • NPI 1033405873
  NPD (past)

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1366243362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 E RIVERSIDE DR STE 6",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847907278",
            "telephone_number": "435-688-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 JEFFERSON WAY STE 102A",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015951",
            "telephone_number": "907-220-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TC PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "435-669-9051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Tacker
• Judith Tacker
• Geoffrey B Taylor, D.O.
• Glenda Taylor
• Jeannette Taylor, PHARMD
• Melissa Tellez
• Temsco Helicopters, Inc.
• Kandi Tetley
• Jessica Teune, MS, RDN, LD
• The Manor LLC

• Pediatric Dentistry in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Pediatric Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.