Jon D Tanner, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D 868 Issued in AK

Legal business name

JON D TANNER, DDS, PC

Practice address

1305 21St Ave
Suite 102
Fairbanks, AK 99701-6084

Phone

(907) 456-5665

Fax

(907) 456-1753

NPI assigned

Apr 3, 2013

Organization subpart

No

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

Authorized official

Name

Jon D Tanner, DDS

Title

President

Phone

(907) 456-5665

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Jonathan J Gerik, D.D.S.

  • Dentist
  • Fairbanks, AK
  • NPI 1538396536
  NPD (past)

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1851634265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 21ST AVE",
            "address_2": "SUITE 102",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016084",
            "telephone_number": "907-456-5665",
            "fax_number": "907-456-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 21ST AVE",
            "address_2": "SUITE 102",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016084",
            "telephone_number": "907-456-5665",
            "fax_number": "907-456-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON D TANNER, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-456-5665",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "D 868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD9416",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "834977",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moriah Johnson, DPT
• Pierre M Johnson, M.D.
• Timothy Oliver Johnson Jr.
• Jasminne Carma Johnston-Conley
• Mary J Johnston, DO
• Jonathan P Woller D.M.D. PC
• Kara Jonathan
• Allyson Jones, MD
• Amy Lynne Jones
• Billi J Jones

• 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 Apr 3, 2013; 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.