Thomas Russell Bird, D.D.S.
Individual provider Active NPI General Practice Dentistry · Eagle River, AK
NPI 1962579367 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962579367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 387 (AK)
- Practice address
- 11723 Old Glenn Hwy
Suite #207
Eagle River, AK 99577-7733 - Phone
- (907) 694-8610
- Fax
- (907) 694-8626
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael G. Crookston DDS PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 387 | AK | Yes |
Addresses
Primary practice location
11723 Old Glenn Hwy
Suite #207
Eagle River, AK 99577-7733
Mailing address
11723 Old Glenn Hwy
Suite #207
Eagle River, AK 99577-7750
Phone (907) 694-8610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD0387 | Medicaid | AK |
Other providers in Eagle River, AK
- Jennifer Bell Ruiz
- Jennifer Benton
- James Benzschawel
- Elisa Renee Betson
- Brooke Erin Bialoblocki
- Elise Bishop
- Maya Brianna Bolak
- Emma Naomi Boswell
- Rachel Boudreau
- Rebecca Anne Bourque
All providers in Eagle River, AK · General Practice Dentistry in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.