Individual provider Active NPI

Andrew Edward Stanya, D.D.S., M.S.

  • Periodontics
  • Fairbanks, AK
National Provider Identifier
1548323710
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
AA 645 Issued in AK
Practice address
1919 Lathrop St
Suite 210
Fairbanks, AK 99701-5930
Phone
(907) 452-1200
Fax
(907) 452-1352
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X AA 645 AK Primary

Addresses

Primary practice location

1919 Lathrop St
Suite 210
Fairbanks, AK 99701-5930

Mailing address

1919 Lathrop St.
Suite 210
Fairbanks, AK 99701-5942
Phone (907) 452-1200

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AA 645AKMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548323710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST.",
            "address_2": "SUITE 210",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015942",
            "telephone_number": "907-452-1200",
            "fax_number": "907-452-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST",
            "address_2": "SUITE 210",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015930",
            "telephone_number": "907-452-1200",
            "fax_number": "907-452-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANYA",
        "first_name": "ANDREW",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AK",
            "license": "AA 645",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.