Individual provider Active NPI

Max Klingenstein, DDS

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1609134790
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10740 Issued in CO
Practice address
4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone
(907) 563-2662
NPI assigned
Apr 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10740 CO Primary
General Practice Dentistry 1223G0001X DD3791 NM

Addresses

Primary practice location

4315 Diplomacy Dr
Anchorage, AK 99508-5926

Mailing address

4506 Camila CT Apt C
Anchorage, AK 99508-2781
Phone (701) 840-2319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209001409 TX Order and Referring Only - DentistPractitioner - Dentist 4284935636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10740COMDGeneral Practice Dentistry
DD3791NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium Current Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Interoperability endpoints

  • Direct secure messaging: mklingenstein@direct.scf.cc

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1609134790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4506 CAMILA CT APT C",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082781",
            "telephone_number": "701-840-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-563-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGENSTEIN",
        "first_name": "MAX",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10740",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.