CORA ROBERTS (NPI# 1205265345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205265345 |
| Entity Type | Individual |
| Full Name | CORA ROBERTS |
| Credential | DHAT |
| Practice Address |
201 3rd Avenue, Suite 115 Seward AK 99664 |
| Mailing Address |
Po Box 103 Hoonah AK 99829-0103 |
| Practice Telephone | 9072244925 |
| Practice Fax Number | 9072244933 |
| Mailing Telephone | 9079453235 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2019-01-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125J00000X | Dental Therapist | 13-114-DHAT | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1603850 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Maquq Street, Nanwalek, AK 996036623 | 9072812250 | 9072812244 |
| 5530 Main Street, Port Graham, AK 996035530 | 9072842241 | 9072842277 |
| 625 Main Street, Chenega Bay, AK 995748029 | 9075735129 | 9075735148 |
| 411 Old Village Road, Tatitlek, AK 996770172 | 9073252235 | 9073252350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952497281 | Cora Jane Roberts | Pharmacist | 733 Market Ave S, Canton, OH 44702-2165 | 2006-10-05 |
| Street Address |
201 3RD AVENUE, SUITE 115 |
| City | SEWARD |
| State | AK |
| Zip Code | 99664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859566 | Benjamin David Sayers I | Behavior Technician | 508 Madison St., Seward, AK 99664 | 2020-10-20 |
| 1497373997 | Hilary Ann Acovak | Behavior Technician | 226 Brownell St., Seward, AK 99664 | 2020-07-10 |
| 1477182368 | Rebecca Snow | Behavior Technician | Seaview Community Services, 302 Railway Avenue, Seward, AK 99664 | 2020-04-03 |
| 1134764996 | Seaview Community Services | Community/Behavioral Health | 1400 Chamberlain St, Seward, AK 99664 | 2019-11-15 |
| 1811544638 | Melissa Sanders | Behavior Technician | 302 Railway, Seward, AK 99664 | 2019-08-26 |
| 1013403708 | Andra Dawn Woodard | Social Worker | 10599 Fox Cir, Seward, AK 99664 | 2018-07-05 |
| 1275020661 | Sarah Brooke Hermann | Massage Therapist | 500 Adams St. Suite 202, Seward, AK 99664 | 2018-04-20 |
| 1902352206 | Lacuna Family Medicine, Inc. | Clinic/Center | 204 4th Ave, Seward, AK 99664 | 2016-08-28 |
| 1992115893 | Carissa Whatmore | Social Worker | 302 Railway Ave., Seward, AK 99664 | 2014-04-30 |
| 1790079721 | Seward Senior Citizens, Inc | In Home Supportive Care | 336 3rd Avenue, Seward, AK 99664 | 2011-06-07 |
| Find all providers in zip 99664 | ||||
| Taxonomy Code | 125J00000X |
| Grouping | Dental Providers |
| Classification | Dental Therapist |
| A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.105. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083251607 | Tamija Katrice Woods | Dental Therapist | 4519 E 4th Ave, Anchorage, AK 99508-2216 | 2019-12-02 |
| 1538541693 | Amanda Miles | Dental Therapist | 3449 E. Rezanof Drive, Dental Department, Kodiak, AK 99615-3449 | 2015-06-25 |
| 1205236692 | Kimberly Baldwin | Dental Therapist | 436 5th Ave Ted Stevens Way, Kotzebue, AK 99752 | 2014-09-04 |
| 1326654245 | Kathrine G.d.a Levi | Dental Therapist | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2020-09-16 |
| 1790320513 | Ruby Okitkun | Dental Therapist | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2019-11-15 |
| 1336783075 | Allison Kristi Wasuli | Dental Therapist | 733 2nd Avenue, Kotzebue, AK 99752 | 2019-11-06 |
| 1922579143 | Janette Carmen Ulak | Dental Therapist | 49 Airport Rd, Hooper Bay Clinic, Hooper Bay, AK 99604 | 2018-12-16 |
| 1609345677 | Samantha Sparks | Dental Therapist | 222 Tongass Dr, Sitka, AK 99835-9416 | 2018-11-19 |
| 1134696156 | Shonna Wheeler | Dental Therapist | 100 Slocum Drive, King Cove, AK 99612 | 2018-10-29 |
| 1881160570 | Leandra Beech | Dental Therapist | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2018-10-19 |
| 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.