NPIMap

Organization Active NPI

Smiles of Alaska LLC

  • Dentist
  • Soldotna, AK
National Provider Identifier
1538270004
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
959 Issued in AK
Legal business name
SMILES OF ALASKA LLC
Practice address
125 N Binkley St
Soldotna, AK 99669-7521
Phone
(907) 262-6466
Fax
(907) 260-3459
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Authorized official

Name
Dr. Jerry CHI Hu, DDSNPI 1619088168
Title
President
Phone
(907) 262-6466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 959 AK Primary

Addresses

Primary practice location

125 N Binkley St
Soldotna, AK 99669-7521

Mailing address

125 N Binkley St
Soldotna, AK 99669-7521
Phone (907) 262-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110203000427 AK DME Supplier - Oral Surgery - Dentist 4486834785 Practice locations: Soldotna, AK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Smiles of Alaska LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

125 N Binkley St
Soldotna, AK 99669
Phone (907) 262-6466

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1538270004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697521",
            "telephone_number": "907-262-6466",
            "fax_number": "907-260-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697521",
            "telephone_number": "907-262-6466",
            "fax_number": "907-260-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES OF ALASKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "HU",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "CHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-262-6466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.