NORTHERN LIGHTS DENTAL ANESTHESIA, LLC (NPI# 1437568409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437568409 |
| Entity Type | Organization |
| Organization Name | NORTHERN LIGHTS DENTAL ANESTHESIA, LLC |
| Practice Address |
1231 W Northern Lights Blvd Ste 623 Anchorage AK 99503-2337 |
| Practice Telephone | 9072683109 |
| Mailing Telephone | 9072683109 |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |
| Authorized Official Name | DR. KENLEY DANE MICHAUD (CEO) |
| Authorized Official Telephone | 9072683109 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
1547 | AK | Dental Providers |
| Street Address |
1231 W NORTHERN LIGHTS BLVD STE 623 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99503-2337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659606739 | Patrick Wayne Campaign | Optometrist | 1231 W Northern Lights Blvd, Suite 423, Anchorage, AK 99503-2337 | 2009-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020772 | Miladis Mcduffie | Massage Therapist | 1350 W. Northern Lights Blvd, Ste C, Anchorage, AK 99503 | 2020-10-15 |
| 1447804984 | Bethany Lynn Becker | Optometrist | 401 E. Northern Lights Blvd. Suite 102, Anchorage, AK 99503 | 2019-08-01 |
| 1265084933 | Carr-gottstein Foods Co | Durable Medical Equipment & Medical Supplies | 2920 Seward Hwy, Anchorage, AK 99503 | 2019-07-12 |
| 1982268942 | Rukiyia Smith | Behavior Technician | 205 E Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-25 |
| 1245894310 | Mary Kathleen Tate | Specialist/Technologist | 205 E. Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-24 |
| 1194295766 | Kimberly Sue Trent | Registered Nurse | 670 W. Fireweed Lane Suite 160, Anchorage, AK 99503 | 2018-11-27 |
| 1659869089 | Alaska Spine & Pain Center, LLC | Chiropractor | 3901 Old Seward Hwy Ste 11, Anchorage, AK 99503 | 2018-05-01 |
| 1235643123 | Rosanne Louise Klouda | Massage Therapist | 213 Fireweed Ln, Anchorage, AK 99503 | 2017-11-30 |
| 1801309042 | Online Care Group Alaska | General Practice | 200 W. 34th Ave, Anchorage, AK 99503 | 2017-11-09 |
| 1548773849 | Leslie K Michalski | Massage Therapist | 510 W Tudor Rd Ste 9, Anchorage, AK 99503 | 2017-11-08 |
| Find all providers in zip 99503 | ||||
| Taxonomy Code | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659784098 | John Leach | Dentist | 205 E Dimond Blvd Ste 200, Anchorage, AK 99515-1909 | 2014-06-03 |
| 1689084550 | Kenley D Michaud | Dentist | 1231 W Northern Lights Blvd Ste 623, Anchorage, AK 99503-2337 | 2014-05-01 |
Please comment or provide details below to improve the information on NORTHERN LIGHTS DENTAL ANESTHESIA, LLC.
| 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.