Kenneth D Oldham, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AA707 Issued in AK

Practice address

3650 Lake Otis Pkwy
Suite 102
Anchorage, AK 99508-5207

Phone

(907) 563-5820

Fax

(907) 562-7029

NPI assigned

Apr 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Frontier Dental, LLC

  • General Practice Dentistry
  • Anchorage, AK
  • NPI 1164685806
  NPD (past)
• Thomas Dental, LLC

  dba Thomas Dental

  • Dentist
  • Anchorage, AK
  • NPI 1982310454
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558589556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PKWY",
            "address_2": "SUITE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085207",
            "telephone_number": "907-563-5820",
            "fax_number": "907-562-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PKWY",
            "address_2": "SUITE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085207",
            "telephone_number": "907-563-5820",
            "fax_number": "907-562-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "AA707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD7070",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christiana Okunor
• Onome T Okurume, APRN, DNP, PMHNP-BC
• Ann Olack, RD, LDN
• Oluwasola Olamikan, M.D.
• Khris Anne Olde
• Alyssa Olds
• Ashlee Olds
• Colleen Olds
• Judson Alexandre Olibrice
• Novena Olibrice, FNP

• General Practice Dentistry in Anchorage, AK
• Providers in Anchorage, AK by specialty
• General Practice Dentistry in Alaska

• 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.