71 17 North Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

71 17 NORTH FAMILY DENTISTRY, LLC

Practice address

1616 Okpik St
Uqtiagvik, AK 99723

Phone

(907) 888-0057

Fax

(907) 479-6410

NPI assigned

Dec 29, 2023

Last updated

Dec 29, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

SPRUCE ROOTS FAMILY DENTISTRY, LLCAs reported in NPPES

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

Authorized official

Name

Chris Willis

Title

Business Manager

Phone

(907) 687-3491

Specialties & licenses 1

Addresses

Part of

Spruce Roots Family Dentistry LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Spruce Roots Family Dentistry, LLC

  • General Practice Dentistry
  • Fairbanks, AK
  • NPI 1013528090
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Ann Willis, D.D.S.

  • Dentist
  • Fairbanks, AK
  • NPI 1841475159
  NPD

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1407625510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 GEIST RD STE 5",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093569",
            "telephone_number": "907-888-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 OKPIK ST",
            "city": "UQTIAGVIK",
            "state": "AK",
            "postal_code": "99723",
            "telephone_number": "907-888-0057",
            "fax_number": "907-479-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "71 17 NORTH FAMILY DENTISTRY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRUCE ROOTS FAMILY DENTISTRY, LLC",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "907-687-3491"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.