Rex C. Malcom Pharmd DMD, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

100531 Issued in AK

Legal business name

REX C. MALCOM PHARMD DMD, LLC

Doing business as

Alaska Advanced Dentistry

Practice address

6917 Old Seward Hwy
Anchorage, AK 99518-2276

Phone

(907) 522-3633

NPI assigned

May 9, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Rex Malcom, DMDNPI 1255454815

Title

Manager

Phone

(907) 522-3633

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alaska Advanced Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rex C. Malcom, PHARM. D, DMD

  • Dentist
  • Anchorage, AK
  • NPI 1255454815
  NPD Authorized official

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1609365105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6917 OLD SEWARD HWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995182276",
            "telephone_number": "907-522-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6917 OLD SEWARD HWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995182276",
            "telephone_number": "907-522-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REX C. MALCOM PHARMD DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "MALCOM",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "907-522-3633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "100531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1642221",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaska Advanced Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Flegont Reutov
• Cynthia L Revels
• Kimberly F Revels, AGACNP-BC
• Revive Alaska Community Services
• Melanie Suzanne Revoltar
• John Rexroth Jr., MPA
• Hans Reyers
• Anna Marie Reyes
• Catherine Reyes, APRN
• Jan Reyes

• Dentist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.