Alfred M Land III, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

6181 Issued in OR

Practice address

10928 Eagle River Rd
Suite 250
Eagle River, AK 99577-8038

Phone

(907) 696-4987

Fax

(907) 696-4991

NPI assigned

Jul 27, 2006

Last updated

Nov 21, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1952325193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10928 EAGLE RIVER RD",
            "address_2": "SUITE 250",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778038",
            "telephone_number": "907-696-4987",
            "fax_number": "907-696-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10928 EAGLE RIVER RD",
            "address_2": "SUITE 250",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778038",
            "telephone_number": "907-696-4987",
            "fax_number": "907-696-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "ALFRED",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "6181",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Kurth
• Jasmyne Lacy
• Jaylon Lacy
• Ryan Lafountaine
• Thomas Joshua Lalor, NP-C
• Alfred Montague Land IV, DMD
• Samantha Lange, LMT
• Mackenzie Larson
• Taylor Rose Larson, ABAT
• Kaylene Lauano

• Dentist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.