49TH State Family Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

49TH STATE FAMILY DENTISTRY LLC

Practice address

10998 Omalley Centre Dr Ste a
Anchorage, AK 99515-3168

Phone

(907) 561-5154

Fax

(907) 561-2253

NPI assigned

Feb 16, 2021

Last updated

Feb 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ellen Donohue, DDSNPI 1114268711

Title

Owner/Member

Phone

(907) 561-5154

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Ellen Donohue, DDS, AEGD

  • Dentist
  • Anchorage, AK
  • NPI 1114268711
  NPD Authorized official

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1669065132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10998 OMALLEY CENTRE DR STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153168",
            "telephone_number": "907-561-5154",
            "fax_number": "907-561-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10998 OMALLEY CENTRE DR STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153168",
            "telephone_number": "907-561-5154",
            "fax_number": "907-561-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "49TH STATE FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "DONOHUE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "907-561-5154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1114268711",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 2 Care Assisted Living Home
• 3 Angels' Assisted Living Home LLC (none)
• 3707 Oregon LLC
• 4 Love 'N' Care Alh, LLC
• 49TH State Care Coordination, LLC
• 4Everhome Assisted Living Home
• 4Everloved Assisted Living Home LLC
• 9 Tales Care Coordination LLC
• A & D Integrated Health LLC (Orion Assisted Living Home)
• A Beautiful Mind Behavior Services L.L.C

• Dental Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dental Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.