Active NPI
John Trimble, DMD
- General Practice Dentistry
- Bethel, AK
National Provider Identifier
1841713872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 124471
- Practice address
- 660 3Rd Ave
Suite C
Bethel, AK 99559 - Phone
- (907) 545-3996
- NPI assigned
- Jul 21, 2017
- Last updated
- Jul 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 124471 | AK | Primary |
Addresses
Primary practice location
660 3Rd Ave
Suite C
Bethel, AK 99559
Mailing address
PO Box 526
Bethel, AK 99559-0526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124471 | AK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keguta Dental LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Bethel, AK
- NPI 1578999306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500595200000",
"number": "1841713872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 526",
"city": "BETHEL",
"state": "AK",
"postal_code": "995590526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 3RD AVE",
"address_2": "SUITE C",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-545-3996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIMBLE",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-21",
"last_updated": "2017-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AK",
"license": "124471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.