Individual provider Active NPI

Steven E Scheller, DDS

  • Dentist
  • Fairbanks, AK
National Provider Identifier
1396840005
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AK1022 Issued in AK
Practice address
4001 Geist Rd Ste 12
Fairbanks, AK 99709-3569
Phone
(907) 452-7955
NPI assigned
Sep 14, 2006
Last updated
Sep 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3534 AR
Dentist 122300000X AK1022 AK Primary

Addresses

Primary practice location

4001 Geist Rd Ste 12
Fairbanks, AK 99709-3569

Mailing address

4001 Geist Rd Ste 12
Fairbanks, AK 99709-3569
Phone (907) 452-7955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180529001545 TX Order and Referring Only - DentistPractitioner - Dentist 9931464757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AK1022AKMDDentist
3534ARMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1396840005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 GEIST RD STE 12",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093569",
            "telephone_number": "907-452-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 GEIST RD STE 12",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093569",
            "telephone_number": "907-452-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLER",
        "first_name": "STEVEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3534",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "AK1022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.