Northern Lights Dental Anesthesia, LLC

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

1547 Issued in AK

Legal business name

NORTHERN LIGHTS DENTAL ANESTHESIA, LLC

Practice address

1231 W Northern Lights Blvd
Ste 623
Anchorage, AK 99503-2337

Phone

(907) 268-3109

NPI assigned

Aug 4, 2014

Last updated

Aug 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenley Dane Michaud, DDSNPI 1689084550

Title

Ceo

Phone

(907) 268-3109

Specialties & licenses 1

Addresses

Locations

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.

• Kenley D Michaud, D.D.S.

  • Dental Anesthesiology
  • Anchorage, AK
  • NPI 1689084550
  NPD Authorized official

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1437568409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E DIMOND BLVD # 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151909",
            "telephone_number": "907-268-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 W NORTHERN LIGHTS BLVD",
            "address_2": "STE 623",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032337",
            "telephone_number": "907-268-3109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Orca Street Unit 1",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "99501",
            "country_code": "US",
            "telephone_number": "907-268-3109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHERN LIGHTS DENTAL ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "MICHAUD",
        "authorized_official_first_name": "KENLEY",
        "authorized_official_middle_name": "DANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-268-3109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "AK",
            "license": "1547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Lights Assisted Living Home LLC
• Northern Lights Care Assisted Living Home
• Northern Lights Care Coordination
• Northern Lights Chiropractic, LLC
• Northern Lights Counseling and Consultation
• Northern Lights Eye Care Inc.
• Northern Lights Living LLC
• Northern Lights Pharmacy, Inc.
• Northern Lights Surgical Associates, P.C.
• Northern Neurology Consultants, LLC.

• Dental Anesthesiology in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dental Anesthesiology in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.