NPIMap

Organization Active NPI

Walther Dental Inc

  • Dentist
  • Wasilla, AK
National Provider Identifier
1942476015
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1038 Issued in AK
Legal business name
WALTHER DENTAL INC
Practice address
1700 E Bogard Rd BLDG B
Wasilla, AK 99654-6563
Phone
(907) 376-9449
Fax
(907) 376-9339
NPI assigned
May 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Mr. Newell A Walther, D.D.S.
Title
Owner
Phone
(907) 376-9449

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 1038 AK Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 1566 AK

Addresses

Primary practice location

1700 E Bogard Rd BLDG B
Wasilla, AK 99654-6563

Mailing address

1700 E Bogard Rd Ste B204
Wasilla, AK 99654-6570
Phone (907) 376-9449

Other identifiers 2

IdentifierTypeStateIssuer
1612641MedicaidAK
1003444MedicaidAK

National Provider Directory

National Provider Directory

Locations

1700 E Bogard Rd
Ste B204
Wasilla, AK 99654
Phone (907) 376-9449

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1942476015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD STE B204",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546570",
            "telephone_number": "907-376-9449",
            "fax_number": "907-376-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD BLDG B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546563",
            "telephone_number": "907-376-9449",
            "fax_number": "907-376-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTHER DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "WALTHER",
        "authorized_official_first_name": "NEWELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-376-9449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "1038",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "1566",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1612641",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003444",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 21, 2016; 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.