NPIMap

Organization Active NPI

Denis S. Corral, D.D.S., P.C.

  • Dentist
  • Eagle River, AK
National Provider Identifier
1649535865
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AA552 Issued in AK
Legal business name
DENIS S. CORRAL, D.D.S., P.C.
Practice address
11901 Business Blvd., #201
Eagle River, AK 99577-7701
Phone
(907) 694-6640
Fax
(907) 694-6681
NPI assigned
Jul 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Dr. Denis S. CorralNPI 1518004498
Title
President / Owner
Phone
(907) 694-6640

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X AA552 AK Primary

Addresses

Primary practice location

11901 Business Blvd., #201
Eagle River, AK 99577-7701

Mailing address

11901 Business Blvd., #201
Eagle River, AK 99577-7701
Phone (907) 694-6640

National Provider Directory

National Provider Directory

Locations

11901 Business Blvd
Ste 201
Eagle River, AK 99577
Phone (907) 694-6640

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1649535865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 BUSINESS BLVD., #201",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777701",
            "telephone_number": "907-694-6640",
            "fax_number": "907-694-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 BUSINESS BLVD., #201",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777701",
            "telephone_number": "907-694-6640",
            "fax_number": "907-694-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENIS S. CORRAL, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "CORRAL",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "907-694-6640",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "AA552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.