Active NPI
Clark Edward, Field Bassham, D.D.S
- Dentist
- Anchorage, AK
National Provider Identifier
1750678447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1420
- Practice address
- 6611 Debarr Rd Ste 200
Anchorage, AK 99504-1706 - Phone
- (907) 337-0404
- NPI assigned
- Jul 1, 2011
- Last updated
- Sep 30, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1420 | AK | Primary |
Addresses
Primary practice location
6611 Debarr Rd Ste 200
Anchorage, AK 99504-1706
Mailing address
6611 Debarr Rd Ste 200
Anchorage, AK 99504-1706
Phone (907) 337-0404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1420 | AK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1750678447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6611 DEBARR RD STE 200",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995041706",
"telephone_number": "907-337-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6611 DEBARR RD STE 200",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995041706",
"telephone_number": "907-337-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASSHAM",
"first_name": "CLARK",
"middle_name": "EDWARD, FIELD",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.