Individual provider Active NPI

Brett Allen Ueeck, M.D., D.M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Anchorage, AK
National Provider Identifier
1437159332
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
120881 Issued in AK
Practice address
3909 Arctic Blvd Ste 404
Anchorage, AK 99503-5769
Phone
(907) 222-5052
Fax
(907) 222-5051
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X D5181OS ID
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 120881 AK Primary

Addresses

Primary practice location

3909 Arctic Blvd Ste 404
Anchorage, AK 99503-5769

Mailing address

PO Box 2489
Sandpoint, ID 83864-0915
Phone (503) 467-9014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
120881AKMDOral & Maxillofacial Surgery (D.M.D.)
D5181OSIDMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Oral Facial and Dental Implant Surgery Oral and Maxillofacial Surgery CurrentSince Dec 10, 2023 Accepting new patients

Locations

11786 SW Barnes Rd
Ste 110
Portland, OR 97225
Phone (503) 444-6444

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1437159332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2489",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640915",
            "telephone_number": "503-467-9014",
            "fax_number": "503-601-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 ARCTIC BLVD STE 404",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035769",
            "telephone_number": "907-222-5052",
            "fax_number": "907-222-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UEECK",
        "first_name": "BRETT",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D., D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "ID",
            "license": "D5181OS",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AK",
            "license": "120881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.