Active NPI
Jonathan J Gerik, D.D.S.
- Dentist
- Fairbanks, AK
National Provider Identifier
1538396536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1350
- Practice address
- 1305 21St Ave
Fairbanks, AK 99701-6084 - Phone
- (907) 456-5665
- Fax
- (907) 456-1753
- NPI assigned
- Jun 17, 2009
- Last updated
- May 15, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 24544 | TX | |
| Dentist | 122300000X | 1350 | AK | Primary |
Addresses
Primary practice location
1305 21St Ave
Fairbanks, AK 99701-6084
Mailing address
1305 21St Ave
Fairbanks, AK 99701-6084
Phone (907) 456-5665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1601351 | Medicaid | AK |
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 |
|---|---|---|---|
| 1350 | AK | MD | Clinical Social Worker |
| 24544 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gerik Dental, Inc | Past | Accepting new patients | |
| Jon D Tanner, DDS, PC | Dentist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Fairbanks, AK
- NPI 1558772277
-
- Dentist
- Fairbanks, AK
- NPI 1851634265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1538396536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 21ST AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997016084",
"telephone_number": "907-456-5665",
"fax_number": "907-456-1753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 21ST AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997016084",
"telephone_number": "907-456-5665",
"fax_number": "907-456-1753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERIK",
"first_name": "JONATHAN",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-17",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "24544",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1601351",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.