NPIMap

Organization Active NPI

Aurora Dental Clinic, LLC

Doing business as Aurora Dental Care

  • General Practice Dentistry
  • Wasilla, AK
National Provider Identifier
1922310432
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
845 Issued in AK
Legal business name
AURORA DENTAL CLINIC, LLC
Doing business as
Aurora Dental Care
Practice address
4501 E Snider Dr
Wasilla, AK 99654-7604
Phone
(907) 376-8400
Fax
(907) 376-8402
NPI assigned
Jul 13, 2010
Last updated
Jul 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Authorized official

Name
Dr. Del Jean Dedeker, D.D.S.
Title
Member/Organizer
Phone
(907) 376-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 845 AK Primary

Addresses

Primary practice location

4501 E Snider Dr
Wasilla, AK 99654-7604

Mailing address

4501 E Snider Dr
Wasilla, AK 99654-7604
Phone (907) 376-8400

Other names 1

  • Aurora Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

4501 E Snider Dr
Wasilla, AK 99654
Phone (907) 376-8400

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1922310432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 E SNIDER DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547604",
            "telephone_number": "907-376-8400",
            "fax_number": "907-676-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 E SNIDER DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547604",
            "telephone_number": "907-376-8400",
            "fax_number": "907-376-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA DENTAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "DEDEKER",
        "authorized_official_first_name": "DEL JEAN",
        "authorized_official_title_or_position": "MEMBER/ORGANIZER",
        "authorized_official_telephone_number": "907-376-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aurora Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.