Peninsula Dental Center

Primary specialty

DentistTaxonomy code 122300000X

License

877 Issued in AK

Legal business name

PENINSULA DENTAL CENTER

Practice address

47707 Judy Lynn Lane
Soldotna, AK 99669

Phone

(907) 283-9125

NPI assigned

Jun 7, 2011

Last updated

Jun 7, 2011By 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

John Selden

Title

President

Phone

(907) 283-9125

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1710271796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2710",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996692710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47707 JUDY LYNN LANE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "99669",
            "telephone_number": "907-283-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "SELDEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-283-9125"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Allergy & Asthma Center LLC
• Peninsula Community Health Services of Alaska, Inc.
• Peninsula Community Health Services of Alaska, Inc.
• Peninsula Dental Center
• Peninsula Dental Center
• Peninsula Eye Clinic, Apc
• Peninsula Health Center Inc.
• Peninsula Health Center, Inc
• Peninsula Hearing Services, Inc.
• Peninsula Instacare

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.