Amanda Shavings, PDHA 1

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

11-082-PDHA1 Issued in AK

Practice address

829 Chief Eddie Hoffman Highway
Bethel, AK 99559-0528

Phone

(907) 827-8111

Fax

(907) 827-8351

NPI assigned

Dec 7, 2011

Last updated

Dec 7, 2011By 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 1

Addresses

Other identifiers 1

Other names 1

• Amanda Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1720356520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "MEKORYUK",
            "state": "AK",
            "postal_code": "996300086",
            "telephone_number": "907-827-2078",
            "fax_number": "907-827-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 CHIEF EDDIE HOFFMAN HIGHWAY",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528",
            "telephone_number": "907-827-8111",
            "fax_number": "907-827-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVINGS",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "PDHA 1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "AK",
            "license": "11-082-PDHA1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PDHA 1 CERTIFICATION NUMBER",
            "identifier": "11-082-PDHA1",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILLIAMS",
            "credential": "PDHA 1",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blake Reza Shahlaie, PA-C
• Natalia Shantz
• Ruby Shantz
• Angela Sharp
• Lena Sharp
• Alan Ray Shear, PA-C
• Kristina Sheldon, EFDHA
• Norma Shorty
• Teresa Simeon-Hunter, COUNSELOR
• Soren S Simeon

• Public Health Dentistry in Bethel, AK
• Providers in Bethel, AK by specialty
• Public Health Dentistry in Alaska

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