Active NPI
Alyssa Mann
- General Practice Dentistry
- Fairchild Afb, WA
National Provider Identifier
1760931216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN-DEN-LIC11600
- Practice address
- 92D Medical Group
701 Hospital Loop Suite 350
Fairchild Afb, WA 99011 - Phone
- (509) 247-4329
- NPI assigned
- Sep 26, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN-DEN-LIC11600 | MT | Primary |
Addresses
Primary practice location
92D Medical Group
701 Hospital Loop Suite 350
Fairchild Afb, WA 99011
Mailing address
92D Medical Group
701 Hospital Loop Suite 350
Fairchild Afb, WA 99011
Phone (509) 247-4329
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 |
|---|---|---|---|
| DEN-DEN-LIC11600 | MT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1760931216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92D MEDICAL GROUP",
"address_2": "701 HOSPITAL LOOP SUITE 350",
"city": "FAIRCHILD AFB",
"state": "WA",
"postal_code": "99011",
"telephone_number": "509-247-4329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92D MEDICAL GROUP",
"address_2": "701 HOSPITAL LOOP SUITE 350",
"city": "FAIRCHILD AFB",
"state": "WA",
"postal_code": "99011",
"telephone_number": "509-247-4329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-26",
"last_updated": "2023-09-07",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "DEN-DEN-LIC11600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairchild Afb, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.