NPIMap

Organization Active NPI

Brett a. Bass, DDS PC

  • Dental Clinic/Center
  • Kodiak, AK
National Provider Identifier
1811150535
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D948 Issued in AK
Legal business name
BRETT A. BASS, DDS PC
Practice address
1317 Mill Bay Rd
Kodiak, AK 99615-6411
Phone
(907) 486-3291
Fax
(907) 486-3015
NPI assigned
Jul 2, 2008
Last updated
Jul 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Brett Alan Bass, DDSNPI 1952310138
Title
Owner
Phone
(907) 486-3291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D948 AK Primary

Addresses

Primary practice location

1317 Mill Bay Rd
Kodiak, AK 99615-6411

Mailing address

1317 Mill Bay Rd
Kodiak, AK 99615-6411
Phone (907) 486-3291

Other identifiers 2

IdentifierTypeStateIssuer
886257OtherAKUNITED CONCORDIA
DD02942MedicaidAK

National Provider Directory

National Provider Directory

Locations

1317 Mill Bay Rd
Kodiak, AK 99615
Phone (907) 486-3291

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1811150535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 MILL BAY RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156411",
            "telephone_number": "907-486-3291",
            "fax_number": "907-486-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 MILL BAY RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156411",
            "telephone_number": "907-486-3291",
            "fax_number": "907-486-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT A. BASS, DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-486-3291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AK",
            "license": "D948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "886257",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD02942",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kodiak, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.