Active NPI
Hans Patrick Nordstrom, DDS
- Dentist
- Wasilla, AK
National Provider Identifier
1487671228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1135
- Practice address
- 1001 E USA Cir
Suite B
Wasilla, AK 99654-7198 - Phone
- (907) 357-6800
- Fax
- (907) 357-6878
- NPI assigned
- Jul 17, 2006
- Last updated
- Oct 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1135 | AK | Primary |
| General Practice Dentistry | 1223G0001X | 1135 | AK |
Addresses
Primary practice location
1001 E USA Cir
Suite B
Wasilla, AK 99654-7198
Mailing address
1001 E USA Cir
Suite B
Wasilla, AK 99654-7198
Phone (907) 357-6800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0053521 | Medicaid | AK | |
| 01634756 | Other | AK | TRICARE |
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 |
|---|---|---|---|
| 1135 | AK | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Orthodontics LLC | Past | Accepting new patients | |
| Hans P. Nordstrom DDS | Dentist | Past | Accepting new patients |
| Kelly Maixner DMD LLC Dba Wee Care Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatric Dentistry
- Wasilla, AK
- NPI 1831677814
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Wasilla, AK
- NPI 1164441119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1487671228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 E USA CIR",
"address_2": "SUITE B",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547198",
"telephone_number": "907-357-6800",
"fax_number": "907-357-6878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 E USA CIR",
"address_2": "SUITE B",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547198",
"telephone_number": "907-357-6800",
"fax_number": "907-357-6878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDSTROM",
"first_name": "HANS",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1135",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AK",
"license": "1135",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0053521",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "01634756",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.