NPIMap

Organization Active NPI

Arctic Slope Native Association

  • Dental Clinic/Center
  • Barrow, AK
National Provider Identifier
1528181971
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DD1010 Issued in AK
Legal business name
ARCTIC SLOPE NATIVE ASSOCIATION
Practice address
1296 Agvik St
Barrow, AK 99723
Phone
(907) 852-4611
Fax
(907) 852-9297
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Amanda Ashley-Gaynor, DMD
Title
Clinical Director of Dental
Phone
(907) 852-4611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DD1010 AK Primary

Addresses

Primary practice location

1296 Agvik St
Barrow, AK 99723

Mailing address

PO Box 29
1296 Agvik St
Barrow, AK 99723-0029
Phone (907) 852-4611

Other identifiers 1

IdentifierTypeStateIssuer
DD1010MedicaidAK

Other names 1

  • Samuel Simmonds Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marshall Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528181971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "address_2": "1296 AGVIK ST",
            "city": "BARROW",
            "state": "AK",
            "postal_code": "997230029",
            "telephone_number": "907-852-4611",
            "fax_number": "907-852-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 AGVIK ST",
            "city": "BARROW",
            "state": "AK",
            "postal_code": "99723",
            "telephone_number": "907-852-4611",
            "fax_number": "907-852-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCTIC SLOPE NATIVE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASHLEY-GAYNOR",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR OF DENTAL",
        "authorized_official_telephone_number": "907-852-4611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AK",
            "license": "DD1010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD1010",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samuel Simmonds Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Barrow, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.