KODIAK AREA NATIVE ASSOCIATION (NPI# 1093213167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093213167 |
| Entity Type | Organization |
| Organization Name | KODIAK AREA NATIVE ASSOCIATION |
| Other Organization Name | FAMILY DENTISTRY OF KODIAK |
| Practice Address |
1317 Mill Bay Rd Kodiak AK 99615-6411 |
| Mailing Address |
3449 E Rezanof Dr Kodiak AK 99615-6952 |
| Practice Telephone | 9074863291 |
| Practice Fax Number | 9074869896 |
| Mailing Telephone | 9074869880 |
| Mailing Fax Number | 9074869896 |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |
| Authorized Official Name | MICHAEL PFEFFER (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9074869800 |
| Is Organization Subpart | Y |
| Parent Organization Name | KODIAK AREA NATIVE ASSOCIATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Dentistry of Kodiak | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467801753 | Kodiak Area Native Association | Clinic/Center | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2016-06-07 |
| 1174948665 | Kodiak Area Native Association | Case Management | 3449 Rezanof Dr E, Kodiak, AK 99615-6952 | 2014-02-20 |
| 1801187471 | Kodiak Area Native Association | Clinic/Center | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2011-04-29 |
| 1679514236 | Kodiak Area Native Association | Clinic/Center | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2006-06-08 |
| 1205883907 | Kodiak Area Native Association | Clinic/Center | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2006-05-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | KODIAK AREA NATIVE ASSOCIATION | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 |
| Street Address |
1317 MILL BAY RD |
| City | KODIAK |
| State | AK |
| Zip Code | 99615-6411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952310138 | Brett Alan Bass | Dentist | 1317 Mill Bay Rd, Kodiak, AK 99615-6411 | 2006-08-05 |
| 1811150535 | Brett A. Bass, Dds PC | Clinic/Center | 1317 Mill Bay Rd, Kodiak, AK 99615-6411 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864232 | Linda Irene Dunlap | Spec/Tech, Pathology | 1915 E. Remanof Drive, Kodiak, AK 99615 | 2019-10-31 |
| 1639638190 | Stephanie Brenteson | Community Health Worker | 125 Airport Way, Akhiok, AK 99615 | 2019-03-14 |
| 1609351022 | Desiree Alexis Wheeler | Optometrist | 3450 E Rezanof Dr, Kodiak, AK 99615 | 2018-10-02 |
| 1417479072 | Elaine Loomis Olsen | Case Manager/Care Coordinator | 1111 Purtov St., Kodiak, AK 99615 | 2017-07-14 |
| 1750828414 | Mary Jean Francisco | Case Manager/Care Coordinator | 717 East Rezanof Drive, Kodiak, AK 99615 | 2017-01-19 |
| 1558818112 | Carolyn Hawes | Case Manager/Care Coordinator | 717 Rezanof Dr, Kodiak, AK 99615 | 2016-09-01 |
| 1285083683 | Amanda Wilson | Community Health Worker | 124 Akhiok Street, Akhiok, AK 99615 | 2016-06-07 |
| 1447612056 | Kailee Champion | Massage Therapist | 3449 Rezanof Drive East, Kodiak, AK 99615 | 2016-03-23 |
| 1376891069 | Krystyna Mcrobert | Technician, Other | Cape Sarichef Road Bldg N46, Rockmore King Clinic, Kodiak, AK 99615 | 2012-08-28 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| Find all providers in zip 99615 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720064884 | Integrated Support Command Kodiak | Clinic/Center | Building N46 Cape Sarichef, Kodiak, AK 99619-5002 | 2005-12-21 |
| 1336391515 | Nathan M Faber Dmd PC | Clinic/Center | 413 E Rezanof Dr, Kodiak, AK 99615-6367 | 2008-10-21 |
| 1811150535 | Brett A. Bass, Dds PC | Clinic/Center | 1317 Mill Bay Rd, Kodiak, AK 99615-6411 | 2008-07-02 |
| 1205883907 | Kodiak Area Native Association | Clinic/Center | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011593 | Deyoung Dentistry, LLC | Clinic/Center | 2601 Boniface Parkway Suite 1, Anchorage, AK 99504 | 2020-07-29 |
| 1205461084 | Hawkinson Dental Inc | Clinic/Center | 6200 Lake Otis Pkwy Ste 101, Anchorage, AK 99507-2098 | 2020-03-11 |
| 1982238622 | Donald R Mclean | Clinic/Center | 3719 E Meridian Loop Ste B, Wasilla, AK 99654-7273 | 2020-03-02 |
| 1740745439 | Susan Olson Dmd Inc | Clinic/Center | 3261 S. Big Lake Rd. Ste D3-d4, Big Lake, AK 99652 | 2019-02-06 |
| 1932664877 | Alaska Family Dental LLC | Clinic/Center | 405 W 36th Ave Ste 101, Anchorage, AK 99503-5872 | 2019-02-05 |
| 1174016737 | Lake Road Dental LLC | Clinic/Center | 4622 Shannon Lake Rd, Dillingham, AK 99576 | 2018-06-08 |
| 1659862134 | Evelyn Haley Dmd | Clinic/Center | 615 E 82nd Ave Ste 100, Anchorage, AK 99518-3100 | 2018-05-21 |
| 1891285433 | Alaskan Family Dental Center LLC | Clinic/Center | 281 N Main St Ste 201, Wasilla, AK 99654-7046 | 2018-05-17 |
| 1376051797 | Caroline Curtis Dmd PC | Clinic/Center | 16635 Centerfield Dr Ste 207, Eagle River, AK 99577-7746 | 2018-01-19 |
| 1417475716 | Michael G. Crookston Dds PC | Clinic/Center | 11723 Old Glenn Hwy Ste 207, Eagle River, AK 99577-7750 | 2017-09-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.