NPIMap

Organization Active NPI

Hans P. Nordstrom DDS

Doing business as Nordstrom Family Dental

  • Dentist
  • Wasilla, AK
National Provider Identifier
1689816969
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1135 Issued in AK
Legal business name
HANS P. NORDSTROM DDS
Doing business as
Nordstrom Family Dental
Practice address
1001 E. USA Circle
Suite B
Wasilla, AK 99654-7198
Phone
(907) 357-6800
NPI assigned
Apr 1, 2009
Last updated
Apr 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Hans P Nordstrom, DDSNPI 1487671228
Title
Owner
Phone
(907) 357-6800

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
Dentist 122300000X 1135 AK Primary

Addresses

Primary practice location

1001 E. USA Circle
Suite B
Wasilla, AK 99654-7198

Mailing address

1001 E. USA Circle
Suite B
Wasilla, AK 99654-7198
Phone (907) 357-6800

Other identifiers 2

IdentifierTypeStateIssuer
01634756OtherUNITED CONCORDIA
DD53521MedicaidAK

Other names 1

  • Nordstrom Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1001 E USA Cir
Ste B
Wasilla, AK 99654
Phone (907) 357-6800

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1689816969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E. USA CIRCLE",
            "address_2": "SUITE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547198",
            "telephone_number": "907-357-6800",
            "fax_number": "907-357-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E. USA CIRCLE",
            "address_2": "SUITE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547198",
            "telephone_number": "907-357-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANS P. NORDSTROM DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "NORDSTROM",
        "authorized_official_first_name": "HANS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-357-6800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "01634756",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD53521",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nordstrom Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.