Active NPI
Timothy M Lethin DDS PC
- Dentist
- Anchorage, AK
National Provider Identifier
1861752560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1133
- Legal business name
- TIMOTHY M LETHIN DDS PC
- Practice address
- 2601 Boniface Pkwy
Suite 2
Anchorage, AK 99504-3144 - Phone
- (907) 337-9474
- NPI assigned
- May 29, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy Lethin, DDS
- Title
- Owner
- Phone
- (907) 337-9474
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1133 | AK | Primary |
| Dentist | 122300000X | 1207 | AK | |
| Dentist | 122300000X | 213 | AK |
Addresses
Primary practice location
2601 Boniface Pkwy
Suite 2
Anchorage, AK 99504-3144
Mailing address
2601 Boniface Pkwy
Suite 2
Anchorage, AK 99504-3144
Phone (907) 337-9474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DDO6052 | Medicaid | AK |
National Provider Directory
National Provider DirectoryLocations
2601 Boniface Pkwy
Ste 2
Anchorage, AK 99504
Phone (907) 222-3033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338249600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1338249600000",
"number": "1861752560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 BONIFACE PKWY",
"address_2": "SUITE 2",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995043144",
"telephone_number": "907-337-9474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 BONIFACE PKWY",
"address_2": "SUITE 2",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995043144",
"telephone_number": "907-337-9474"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIMOTHY M LETHIN DDS PC",
"organizational_subpart": "NO",
"enumeration_date": "2012-05-29",
"last_updated": "2012-05-29",
"status": "A",
"authorized_official_last_name": "LETHIN",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "907-337-9474",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "AK",
"license": "1133",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "AK",
"license": "1207",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "AK",
"license": "213",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DDO6052",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.