Lara M. Mabry, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1200 Issued in AK

Practice address

2601 Boniface Pkwy
Anchorage, AK 99504-3106

Phone

(907) 337-9448

Fax

(907) 337-4123

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 4, 2023 through Jan 4, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Mabry and Mabry Dentistry, LLC

  • Dental Clinic/Center
  • Anchorage, AK
  • NPI 1154672558
  NPD (past) Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780737395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 BONIFACE PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043106",
            "telephone_number": "907-337-9448",
            "fax_number": "907-337-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 BONIFACE PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043106",
            "telephone_number": "907-337-9448",
            "fax_number": "907-337-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "LARA",
        "middle_name": "M.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD2601",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ma, PHARMD
• Connie Maafala-Loapo
• Helen Maafala
• Sayaka Maas, LPC
• Mabry and Mabry Dentistry, LLC
• Ghislaine Aurore Mabudu
• Mabuhay Health Care Services LLC
• Evalynn Mac
• Abygel Ruelos Macadaan
• Blandina Macaraeg

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.