Heather Ann Willis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

1252 Issued in AK

Practice address

4001 Geist Rd Ste 5
Fairbanks, AK 99709-3569

Phone

(907) 479-3326

Fax

(907) 479-6410

NPI assigned

Jan 4, 2008

Last updated

May 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 71 17 North Family Dentistry, LLC

  • General Practice Dentistry
  • Uqtiagvik, AK
  • NPI 1407625510
  NPD
• Spruce Roots Family Dentistry, LLC

  • General Practice Dentistry
  • Fairbanks, AK
  • NPI 1013528090
  NPD

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1841475159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 GEIST RD STE 5",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093569",
            "telephone_number": "907-479-3326",
            "fax_number": "907-479-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 GEIST RD STE 5",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093569",
            "telephone_number": "907-479-3326",
            "fax_number": "907-479-6410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 Okpik St",
            "address_purpose": "LOCATION",
            "city": "Utqiagvik",
            "state": "AK",
            "postal_code": "99723",
            "country_code": "US",
            "telephone_number": "907-888-0057",
            "fax_number": "907-479-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Williams
• Brenda Jean Williamson
• Christina Williamson
• Connor Michael Williamson
• Brian R Willis, M.D.
• Willow Physical Therapy, Limited
• Anjela Kelli Wilmot
• Cassandra Rene' Wilson-McMillan
• Angell D Wilson
• Caleb Wilson

• Dentist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.