Organization Active NPI

Timothy M Lethin DDS PC

  • Dentist
  • Anchorage, AK
National Provider Identifier
1861752560
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1133 Issued in AK
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

Updated by the provider on May 29, 2012

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)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 1133 AK Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 1207 AK
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
DDO6052MedicaidAK

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.