Jonathan P Woller D.M.D. PC

Primary specialty

DentistTaxonomy code 122300000X

License

1155 Issued in AK

Legal business name

JONATHAN P WOLLER D.M.D. PC

Practice address

3535 College Rd
Suite #205
Fairbanks, AK 99709-3722

Phone

(907) 479-6747

Fax

(907) 479-5786

NPI assigned

Dec 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Patrick Woller, D.M .D.NPI 1144385659

Title

President

Phone

(907) 479-6747

Specialties & licenses 1

Addresses

Practitioners 2

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

• Jonathan P Woller, D.M.D.

  • Dentist
  • Fairbanks, AK
  • NPI 1144385659
  NPD (past) Authorized official
• Timothy John Woller, D.D.S.

  • General Practice Dentistry
  • Fairbanks, AK
  • NPI 1356565659
  NPD (past)

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1407159775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 COLLEGE RD",
            "address_2": "SUITE #205",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093722",
            "telephone_number": "907-479-6747",
            "fax_number": "907-479-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 COLLEGE RD",
            "address_2": "SUITE #205",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093722",
            "telephone_number": "907-479-6747",
            "fax_number": "907-479-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN P WOLLER D.M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "WOLLER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-479-6747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M .D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pierre M Johnson, M.D.
• Timothy Oliver Johnson Jr.
• Jasminne Carma Johnston-Conley
• Mary J Johnston, DO
• Jon D Tanner, DDS, PC
• Kara Jonathan
• Allyson Jones, MD
• Amy Lynne Jones
• Billi J Jones
• Jeremy Samuel Jones, BEHAVIOR TECHNICIAN

• Dentist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; 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.