Kristen Leigh Whetsell, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

15707 Issued in AK

Practice address

3112 Airport Way Ste 1
Fairbanks, AK 99709-4768

Phone

(907) 452-1250

NPI assigned

Jul 17, 2012

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

University of Maryland at Baltimore School of Dentistry, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairbanks Dental Center LLC

  dba Fairbanks Dental Center

  • Dentist
  • Fairbanks, AK
  • NPI 1831550631
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1710232707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 AIRPORT WAY STE 1",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094768",
            "telephone_number": "907-452-1250",
            "fax_number": "907-456-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 AIRPORT WAY STE 1",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094768",
            "telephone_number": "907-452-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETSELL",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "157077",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AK",
            "license": "15707",
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "AK",
            "license": "15707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronnie Whaley
• Janet Whatley, ANP
• Jamie Bazzanella Wheatley
• Evan L. Wheeler, D.D.S
• Jamie Wheeler
• Jason L. Whipple, PHD
• Deborah Whistler
• Robert Whitaker
• White Spruce Medical Inc
• White Spruce Medical, LLC

• Oral and Maxillofacial Surgery (Dentist) in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.