NPIMap

Organization Active NPI

Fairbanks Dental Center LLC

Doing business as Fairbanks Dental Center

  • Dentist
  • Fairbanks, AK
National Provider Identifier
1831550631
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FAIRBANKS DENTAL CENTER LLC
Doing business as
Fairbanks Dental Center
Practice address
3112 Airport Way
Suite 1
Fairbanks, AK 99709-4768
Phone
(907) 452-1250
Fax
(907) 456-1307
NPI assigned
Mar 8, 2016
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
Kristen Leigh Whetsell, DDSNPI 1710232707
Title
Owner
Phone
(907) 452-1250

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X
Dentist 122300000X Primary
General Practice Dentistry 1223G0001X
Orofacial Pain Dentistry 1223X2210X

Addresses

Primary practice location

3112 Airport Way
Suite 1
Fairbanks, AK 99709-4768

Mailing address

3112 Airport Way Ste 1
Fairbanks, AK 99709-4768
Phone (907) 452-1250

Other names 1

  • Fairbanks Dental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161112000405 AK DME Supplier - Oral Surgery - Dentist 7315226404 Practice locations: Fairbanks, AK
O20231206000320 AK Part B Supplier - Clinic/Group Practice 7315226404 Receives reassigned benefits from 2 practitioners
Practice locations: Fairbanks, AK

National Provider Directory

National Provider Directory

Locations

3112 Airport Way
Ste 1
Fairbanks, AK 99709
Phone (907) 452-1250

Practitioners & affiliated clinicians

Practitioners 6

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": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1831550631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 AIRPORT WAY STE 1",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094768",
            "telephone_number": "907-452-1250",
            "fax_number": "907-456-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 AIRPORT WAY",
            "address_2": "SUITE 1",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094768",
            "telephone_number": "907-452-1250",
            "fax_number": "907-456-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "WHETSELL",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-452-1250",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairbanks Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairbanks Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.