Active NPI
Vickey J Hodnik, D.D.S.
- Dentist
- Homer, AK
National Provider Identifier
1427277359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 692
- Practice address
- 4014 Lake St
Suite 210
Homer, AK 99603-7651 - Phone
- (907) 235-7585
- Fax
- (907) 235-7311
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 692 | AK | Primary |
Addresses
Primary practice location
4014 Lake St
Suite 210
Homer, AK 99603-7651
Mailing address
4014 Lake St
Suite 210
Homer, AK 99603-7651
Phone (907) 235-7585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 692 | AK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anne C Adamson DDS LLC | Past | Accepting new patients | |
| Homer Dental Center Inc | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Homer, AK
- NPI 1962778001
-
- General Practice Dentistry
- Homer, AK
- NPI 1164012092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427277359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4014 LAKE ST",
"address_2": "SUITE 210",
"city": "HOMER",
"state": "AK",
"postal_code": "996037651",
"telephone_number": "907-235-7585",
"fax_number": "907-235-7311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4014 LAKE ST",
"address_2": "SUITE 210",
"city": "HOMER",
"state": "AK",
"postal_code": "996037651",
"telephone_number": "907-235-7585",
"fax_number": "907-235-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODNIK",
"first_name": "VICKEY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.