Janette Carmen Ulak

Individual provider Active NPI Dental Therapist · Hooper Bay, AK

NPI 1922579143 · NPPES record last updated Dec 16, 2018

Key facts

NPI
1922579143
Entity type
Individual (NPI type 1)
Primary specialty
Dental Therapist 125J00000X
License
07-046-DHAT (AK)
Practice address
49 Airport Rd
Hooper Bay Clinic
Hooper Bay, AK 99604
Phone
(907) 758-3500
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
07-046-DHATAKMDDental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X 07-046-DHAT AK Yes

Addresses

Primary practice location

49 Airport Rd
Hooper Bay Clinic
Hooper Bay, AK 99604

Mailing address

PO Box 528
Bethel, AK 99559-0528
Phone (907) 543-6229

Other providers in Hooper Bay, AK

All providers in Hooper Bay, AK · Dental Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.