Individual provider Active NPI

Samantha Conner, DHAT

  • Dental Therapist
  • Sitka, AK
National Provider Identifier
1609345677
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental TherapistTaxonomy code 125J00000X
License
18-152 Issued in AK
Practice address
222 Tongass Dr
Sitka, AK 99835-9416
Phone
(907) 668-3439
NPI assigned
Nov 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X 18-152 AK Primary

Addresses

Primary practice location

222 Tongass Dr
Sitka, AK 99835-9416

Mailing address

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 668-3439

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

LicenseStateTypeSpecialty
18-152AKMDDental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1609345677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-668-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-668-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "SAMANTHA",
        "credential": "DHAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "AK",
            "license": "18-152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.