NPIMap

Organization Active NPI

Kelly Maixner DMD LLC Dba Wee Care Pediatric Dentistry

  • Pediatric Dentistry
  • Wasilla, AK
National Provider Identifier
1831677814
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1248 Issued in AK
Legal business name
KELLY MAIXNER DMD LLC DBA WEE CARE PEDIATRIC DENTISTRY
Practice address
1001 E USA Cir Ste B
Wasilla, AK 99654-7198
Phone
(907) 373-6000
Fax
(907) 357-6878
NPI assigned
Aug 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Misti Forrest
Title
Manager
Phone
(907) 373-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 1248 AK Primary

Addresses

Primary practice location

1001 E USA Cir Ste B
Wasilla, AK 99654-7198

Mailing address

1001 E USA Cir Ste B
Wasilla, AK 99654-7198
Phone (907) 373-6000

Other identifiers 1

IdentifierTypeStateIssuer
1003575MedicaidAK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1831677814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E USA CIR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547198",
            "telephone_number": "907-373-6000",
            "fax_number": "907-357-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E USA CIR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547198",
            "telephone_number": "907-373-6000",
            "fax_number": "907-357-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY MAIXNER DMD LLC DBA WEE CARE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "907-373-6000"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AK",
            "license": "1248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003575",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.