DR. KENNETH D OLDHAM (NPI# 1558589556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558589556 |
| Entity Type | Individual |
| Full Name | DR. KENNETH D OLDHAM |
| Credential | D.M.D. |
| Practice Address |
3650 Lake Otis Pkwy Suite 102 Anchorage AK 99508-5207 |
| Practice Telephone | 9075635820 |
| Practice Fax Number | 9075627029 |
| Mailing Telephone | 9075635820 |
| Mailing Fax Number | 9075627029 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
AA707 | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DD7070 | 05 |
| Street Address |
3650 LAKE OTIS PKWY SUITE 102 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851391395 | David Dixon Beal | Otolaryngology | 3650 Lake Otis Pkwy, Suite 100, Anchorage, AK 99508-5218 | 2005-07-27 |
| 1093113904 | Meera Parekh | Physical Therapist | 3650 Lake Otis Pkwy, #201, Anchorage, AK 99508-5218 | 2014-12-09 |
| 1841612132 | Last Frontier Neurosurgery | Specialist | 3650 Lake Otis Pkwy, Suite 202, Anchorage, AK 99508-5218 | 2014-01-06 |
| 1609121995 | Nicole Keane | Massage Therapist | 3650 Lake Otis Pkwy, Suite 201, Anchorage, AK 99508-5218 | 2012-07-23 |
| 1255629614 | Joanna Renae Austin | Physical Therapist | 3650 Lake Otis Pkwy, Suite 201, Anchorage, AK 99508-5218 | 2011-07-19 |
| 1639300833 | Michelle R Dreeszen | Physical Therapist | 3650 Lake Otis Pkwy, Suite 201, Anchorage, AK 99508-5218 | 2009-08-05 |
| 1164685806 | Frontier Dental, LLC | Dentist | 3650 Lake Otis Pkwy, Ste 102, Anchorage, AK 99508-5218 | 2008-07-02 |
| 1356553655 | Paula Korn | Advanced Practice Midwife | 3650 Lake Otis Pkwy, Suite 140, Anchorage, AK 99508-5207 | 2007-05-07 |
| 1639222425 | Michael D Brandner | Surgery | 3650 Lake Otis Pkwy, Suite #100, Anchorage, AK 99508 | 2007-01-18 |
| 1821159674 | Robert K Thornquist | Family Medicine | 3650 Lake Otis Pkwy, Suite 104, Anchorage, AK 99508-5207 | 2006-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568024388 | North Coast Dental LLC | Dentist | 2020 Abbott Rd Ste 1, Anchorage, AK 99507-4624 | 2019-07-01 |
| 1215433768 | Ryan P. Ersland, D.m.d. LLC | Dentist | 2525 Gambell St Ste 304a, Anchorage, AK 99503-2838 | 2018-04-03 |
| 1699289645 | Jae Won Lee | Dentist | 726 E. 9th Avenue, Anchorage, AK 99501 | 2017-11-29 |
| 1295271492 | Maurice J Welch Dds A Professional Corporation | Dentist | 4450 Cordova St Ste 210, Anchorage, AK 99503-7273 | 2017-01-11 |
| 1811355456 | Geon Bae | Dentist | 3340 Providence Dr Ste 552, Anchorage, AK 99508 | 2016-02-09 |
| 1326421850 | Hyrum Murdoch | Dentist | 4200 Lake Otis Pkwy Ste 201, Anchorage, AK 99508-5226 | 2015-07-01 |
| 1043603194 | Keith D. Mcgranahan | Dentist | 1407 W 31st St., Anchorage, AK 99503 | 2015-03-13 |
| 1376941260 | Joshua Michael Kennedy | Dentist | 625 E 34th Ave Ste 301, Anchorage, AK 99503-4154 | 2014-12-09 |
| 1649609439 | Smiles Dental Alaska, LLC | Dentist | 9138 Arlon St Ste B, Anchorage, AK 99507-3876 | 2013-11-02 |
| 1790027134 | Healthy Smiles Forever, LLC | Dentist | 5576 Sapphire Loop, Anchorage, AK 99504-6000 | 2013-03-25 |
| Find all providers in ANCHORAGE | ||||
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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.