Individual provider Active NPI

Anne C Adamson, DDS

  • General Practice Dentistry
  • Homer, AK
National Provider Identifier
1497130926
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
166942 Issued in AK
Practice address
4014 Lake St Ste 210
Homer, AK 99603-7692
Phone
(907) 235-7585
NPI assigned
Jul 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021660 MI
General Practice Dentistry 1223G0001X 166942 AK Primary

Addresses

Primary practice location

4014 Lake St Ste 210
Homer, AK 99603-7692

Mailing address

4014 Lake St Ste 210
Homer, AK 99603-7692
Phone (907) 235-7585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 1, 2023 through Aug 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901021660MIMDDentist
166942AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Anne C Adamson DDS LLC General Practice CurrentSince Jan 31, 2021 Accepting new patients
Homer Dental Center Inc Dentist PastSince Jan 31, 2021 Accepting new patients

Locations

4014 Lake St
Ste 210
Homer, AK 99603
Phone (907) 235-7585

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": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1497130926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 LAKE ST STE 210",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037692",
            "telephone_number": "907-235-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LAKE ST STE 210",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037692",
            "telephone_number": "907-235-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMSON",
        "first_name": "ANNE",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021660",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "166942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

Verify at the official NPI Registry.