Active NPI
Brian NG, DMD
- Dentist
- Elmendorf AFB, AK
National Provider Identifier
1558925669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.032317
- Practice address
- 5955 Zeamer Ave BLDG 5955
Elmendorf AFB, AK 99506-3702 - Phone
- (907) 580-5010
- NPI assigned
- Apr 24, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.032317 | IL | Primary |
Addresses
Primary practice location
5955 Zeamer Ave BLDG 5955
Elmendorf AFB, AK 99506-3702
Mailing address
5955 Zeamer Ave BLDG 5955
Elmendorf AFB, AK 99506-3702
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 |
|---|---|---|---|
| 019.032317 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631059200000",
"number": "1558925669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE BLDG 5955",
"city": "ELMENDORF AFB",
"state": "AK",
"postal_code": "995063702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE BLDG 5955",
"city": "ELMENDORF AFB",
"state": "AK",
"postal_code": "995063702",
"telephone_number": "907-580-5010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NG",
"first_name": "BRIAN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-24",
"last_updated": "2021-09-08",
"certification_date": "2021-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.032317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmendorf AFB, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.