Vanity: Aesthetics, Dermatology & Wellness, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

PADA1252 Issued in AK

Legal business name

VANITY: AESTHETICS, DERMATOLOGY & WELLNESS, LLC

Practice address

431 W 7TH Ave Ste 204
Anchorage, AK 99501-3500

Phone

(907) 250-2511

Fax

(888) 908-9442

NPI assigned

Jun 8, 2018

Organization subpart

No

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

Authorized official

Name

Jesika Harrell, PA

Title

Member

Phone

(904) 716-8955

Specialties & licenses 2

Addresses

Other names 1

• Vanity Doing business as

Locations

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1790278356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 W 7TH AVE STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995013500",
            "telephone_number": "907-250-2511",
            "fax_number": "888-908-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W 7TH AVE STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995013500",
            "telephone_number": "907-250-2511",
            "fax_number": "888-908-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Benson Blvd Ste 103C",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995034148",
            "country_code": "US",
            "telephone_number": "907-250-2511",
            "fax_number": "888-908-9442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2221 Jordan Ave Ste 103C",
            "address_purpose": "LOCATION",
            "city": "Juneau",
            "state": "AK",
            "postal_code": "998018050",
            "country_code": "US",
            "telephone_number": "907-250-2511",
            "fax_number": "888-908-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VANITY: AESTHETICS, DERMATOLOGY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "JESIKA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "904-716-8955",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "PADA1252",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AK",
            "license": "PADA1252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• PA Lou Vang
• Yee Vang
• Lara Vanhoozer, PA-C
• Rexford Asolelei Vanilau
• Roddy Vanilau
• Kara Dawn Vankooten, PT, DPT
• Aimee Vanommeren
• Jo Ann Vanoort, C.C.
• Jonathan Mark Vanravenswaay, MD
• Daisy Vanslyke, BSW

• Multi-Specialty Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Multi-Specialty Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.