Active NPI
Janet H Amuktoolik, DENTAL ASSISTANT
- Dental Assistant
- Nome, AK
National Provider Identifier
1992072417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 05-020-EFDHA
- Practice address
- 306 West 5TH Ave
Nome, AK 99762 - Phone
- (907) 443-3311
- NPI assigned
- Nov 29, 2011
- Last updated
- Nov 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 05-020-EFDHA | AK | Primary |
Addresses
Primary practice location
306 West 5TH Ave
Nome, AK 99762
Mailing address
306 West 5TH Ave
Nome, AK 99762
Phone (907) 443-3311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05-020-EFDHA | Other | AK | 05-020-EFDHA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05-020-EFDHA | AK | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1992072417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 WEST 5TH AVE",
"city": "NOME",
"state": "AK",
"postal_code": "99762",
"telephone_number": "907-443-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 WEST 5TH AVE",
"city": "NOME",
"state": "AK",
"postal_code": "99762",
"telephone_number": "907-443-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMUKTOOLIK",
"first_name": "JANET",
"middle_name": "H",
"credential": "DENTAL ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-29",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "AK",
"license": "05-020-EFDHA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "05-020-EFDHA",
"identifier": "05-020-EFDHA",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nome, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.