William Randy Deeter, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

654 Issued in AK

Practice address

111 W 16TH Ave
Suite 203
Anchorage, AK 99501-6206

Phone

(907) 561-1430

Fax

(907) 561-2697

NPI assigned

Jul 28, 2006

Last updated

Apr 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Oral Surgery Associates of Alaska

  • Oral and Maxillofacial Surgery (Dentist)
  • Anchorage, AK
  • NPI 1346254851
  Authorized official Same address or phone

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1457365827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W 16TH AVE",
            "address_2": "SUITE 203",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995016206",
            "telephone_number": "907-561-1430",
            "fax_number": "907-561-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 16TH AVE",
            "address_2": "SUITE 203",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995016206",
            "telephone_number": "907-561-1430",
            "fax_number": "907-561-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETER",
        "first_name": "WILLIAM",
        "middle_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AK",
            "license": "654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE ID",
            "identifier": "480642",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0654",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Decarlo, OT
• Aaron M Dechant, DC
• David Mark Decker, PA
• Mary Decourcey
• Nathan Earl Deeter
• Deford Rolfing LLC
• Marnie Deford
• Shawn Deford
• Edward Flynn Deforest, RT
• Gilia Degange

• Oral and Maxillofacial Surgery (Dentist) in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.