NPIMap

Organization Active NPI

Keguta Dental LLC

  • Dental Clinic/Center
  • Bethel, AK
National Provider Identifier
1578999306
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D997 Issued in AK
Legal business name
KEGUTA DENTAL LLC
Practice address
660 Third Ave Ste C
Bethel, AK 99559-0169
Phone
(907) 545-3996
NPI assigned
Sep 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Authorized official

Name
Edwin H Allgair Jr., DDSNPI 1104948884
Title
Dental Director/Manager
Phone
(206) 419-0787

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
Dental Clinic/Center 261QD0000X D997 AK Primary

Addresses

Primary practice location

660 Third Ave Ste C
Bethel, AK 99559-0169

Mailing address

PO Box 1051
Sterling, AK 99672-1051
Phone (206) 419-0787

Other identifiers 1

IdentifierTypeStateIssuer
1608341MedicaidAK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1578999306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1051",
            "city": "STERLING",
            "state": "AK",
            "postal_code": "996721051",
            "telephone_number": "206-419-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 THIRD AVE STE C",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590169",
            "telephone_number": "907-545-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEGUTA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "ALLGAIR",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTAL DIRECTOR/MANAGER",
        "authorized_official_telephone_number": "206-419-0787",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AK",
            "license": "D997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1608341",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.