NPIMap

Individual provider Active NPI

Christopher G Fearon, DMD

  • Dentist
  • Fort Richardson, AK
National Provider Identifier
1982771473
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1157 Issued in AK
Practice address
Building 634, Postal Loop 7500
US Army Dental Clinic
Fort Richardson, AK 99505-7500
Phone
(907) 384-3079
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1157 AK Primary

Addresses

Primary practice location

Building 634, Postal Loop 7500
US Army Dental Clinic
Fort Richardson, AK 99505-7500

Mailing address

Building 634 Postal Loop 7500
US Army Dental Clinic
Fort Richardson, AK 99505-7500
Phone (907) 384-3079

Other identifiers 1

IdentifierTypeStateIssuer
DD115FQMedicaidAK

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1157AKMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1982771473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BUILDING 634 POSTAL LOOP 7500",
            "address_2": "US ARMY DENTAL CLINIC",
            "city": "FORT RICHARDSON",
            "state": "AK",
            "postal_code": "995057500",
            "telephone_number": "907-384-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 634, POSTAL LOOP 7500",
            "address_2": "US ARMY DENTAL CLINIC",
            "city": "FORT RICHARDSON",
            "state": "AK",
            "postal_code": "995057500",
            "telephone_number": "907-384-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARON",
        "first_name": "CHRISTOPHER",
        "middle_name": "G",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD115FQ",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Richardson, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.