Individual provider Active NPI

Dexter Allen, MD

  • Orthopaedic Surgery Physician
  • Fort Wainwright, AK
National Provider Identifier
1437711256
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
236799 Issued in AK
Practice address
4076 Neely Road
Fort Wainwright, AK 99703
Phone
(907) 361-5172
NPI assigned
Jul 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 236799 AK Primary

Addresses

Primary practice location

4076 Neely Road
Fort Wainwright, AK 99703

Mailing address

4076 Neely Road
Fort Wainwright, AK 99703

Other practice location 1

1650 Cowles St
Fairbanks, AK 99701-5998
Phone (907) 459-3545

Other identifiers 1

IdentifierTypeStateIssuer
1761602MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260213003132 AK Practitioner - Orthopedic Surgery 5193205672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Vermont College of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1001 Noble St
Suite 460
Fairbanks, AK 99701-4948

1650 Cowles St
Fairbanks, AK 99701-5998

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236799AKMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Valley Clinic LLC CurrentSince Jan 5, 2026 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Jan 5, 2026 Accepting new patients

Locations

1919 Lathrop St
Ste 105
Fairbanks, AK 99701
Phone (907) 374-1089

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

1919 Lathrop St
Fairbanks, AK 99701
Phone (907) 459-3570

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1437711256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cowles St",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997015998",
            "country_code": "US",
            "telephone_number": "907-459-3545",
            "fax_number": "907-328-0474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DEXTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "236799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1761602",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wainwright, AK

Sources for this page

Verify at the official NPI Registry.