Alfred Montague Land IV, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1275 Issued in AK

Practice address

10928 Eagle River Rd
Suite 250
Eagle River, AK 99577-8038

Phone

(907) 696-4987

NPI assigned

Sep 3, 2008

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1831347889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 E BOGARD RD",
            "address_2": "SUITE 203",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547175",
            "telephone_number": "907-376-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10928 EAGLE RIVER RD",
            "address_2": "SUITE 250",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778038",
            "telephone_number": "907-696-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "ALFRED",
        "middle_name": "MONTAGUE",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1275",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmyne Lacy
• Jaylon Lacy
• Ryan Lafountaine
• Thomas Joshua Lalor, NP-C
• Alfred M Land III, D.M.D
• Samantha Lange, LMT
• Mackenzie Larson
• Taylor Rose Larson, ABAT
• Kaylene Lauano
• Brooklyn Rose Lausier

• General Practice Dentistry in Eagle River, AK
• Providers in Eagle River, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.