GAMALIEL I. RODRIGUEZ, DDS, PC (NPI# 1558726489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558726489 |
| Entity Type | Organization |
| Organization Name | GAMALIEL I. RODRIGUEZ, DDS, PC |
| Other Organization Name | NORTHERN LIGHTS DENTAL CLINIC |
| Practice Address |
2595 Saint Nicholas Dr North Pole AK 99705-7747 |
| Practice Telephone | 9074904629 |
| Practice Fax Number | 9074904649 |
| Mailing Telephone | 9074904629 |
| Mailing Fax Number | 9074904649 |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2015-12-18 |
| Authorized Official Name | GAMALIEL ISSAC RODRIGUEZ (OWNER) |
| Authorized Official Telephone | 9074900127 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
AA828 | AK | Dental Providers |
| Other Name | Type Code |
|---|---|
| Northern Lights Dental Clinic | Doing Business As Name - Organization |
| Street Address |
2595 SAINT NICHOLAS DR |
| City | NORTH POLE |
| State | AK |
| Zip Code | 99705-7747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508870684 | Edgar Alan Stewart | Dentist | 2595 Saint Nicholas Dr, North Pole, AK 99705-7747 | 2006-07-27 |
| 1770597833 | Gamaliel Issac Rodriguez | Dentist | 2595 Saint Nicholas Dr, North Pole, AK 99705-7747 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225508815 | Madison Grove | Behavioral Analyst | 203 S. Santa Claus Lane, North Pole, AK 99705 | 2018-11-27 |
| 1104393123 | Jessica Marie Childress | Behavioral Analyst | 203 Santa Clause, North Pole, AK 99705 | 2018-10-29 |
| 1346722279 | Kimberly Shriner | Student in an Organized Health Care Education/Training Program | 1970 Hollowell Rd, North Pole, AK 99705 | 2018-09-06 |
| 1780108993 | Tracy Norris | Behavior Technician | 1000 Borda St., North Pole, AK 99705 | 2017-07-29 |
| 1912134420 | Donald Jermome Kosatka | Psychiatry & Neurology | Building 4066 602nd Street, Bassett Army Community Hospital, Fort Wainwright, AK 99705 | 2009-06-11 |
| 1174796247 | Monique Dase Smith | Psychiatry & Neurology | 1650 Cowles St., Fairbanks, AK 99705 | 2008-04-09 |
| 1376742494 | Vicki Elaine Readnour | Physical Therapist | 167-b Santa Claus Lane, North Pole, AK 99705 | 2007-07-18 |
| 1114091527 | Helyn M Lefgren | Family Medicine | 145 Santa Claus Lane, North Pole, AK 99705 | 2006-11-17 |
| 1174695803 | Eric P Buetow | Dentist | 2933 Horseshoe Way, North Pole, AK 99705 | 2006-11-15 |
| 1770578296 | North Pole Prescription Laboratory Inc | Pharmacy | 167 Santa Claus Lane, North Pole, AK 99705 | 2005-09-12 |
| Find all providers in zip 99705 | ||||
| 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 |
|---|---|---|---|---|
| 1346640331 | Jeremy Bauer Dds LLC | Dentist | 203 S Santa Claus Ln Ste B, North Pole, AK 99705-7704 | 2014-08-27 |
| 1164569299 | Troy R Burns | Dentist | 203 S Santa Claus Ln, North Pole, AK 99705-7704 | 2007-01-30 |
| 1508870684 | Edgar Alan Stewart | Dentist | 2595 Saint Nicholas Dr, North Pole, AK 99705-7747 | 2006-07-27 |
| 1861681959 | Eric P. Buetow, D.d.s., P.C. | Dentist | 2933 Horseshoe Way, North Pole, AK 99705-6122 | 2007-10-15 |
| 1770597833 | Gamaliel Issac Rodriguez | Dentist | 2595 Saint Nicholas Dr, North Pole, AK 99705-7747 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760034524 | Erin Winters | Dentist | 3706 Swenson Ave, Fairbanks, AK 99709-4643 | 2019-07-11 |
| 1063064863 | Alan Bartelli | Dentist | 1700 E Bogard Rd Ste 204, Wasilla, AK 99654-6563 | 2019-07-11 |
| 1568024388 | North Coast Dental LLC | Dentist | 2020 Abbott Rd Ste 1, Anchorage, AK 99507-4624 | 2019-07-01 |
| 1558852954 | Soldotna Family Dental | Dentist | 36297 Kenai Spur Hwy, Soldotna, AK 99669-7106 | 2018-05-22 |
| 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 |
| 1841713872 | John Trimble | Dentist | 660 3rd Ave, Suite C, Bethel, AK 99559 | 2017-07-21 |
| 1255853388 | Brett Croft Kocherhans | Dentist | 1401 S Seward Meridian Pkwy Ste E, Wasilla, AK 99654-8312 | 2017-07-11 |
| 1295271492 | Maurice J Welch Dds A Professional Corporation | Dentist | 4450 Cordova St Ste 210, Anchorage, AK 99503-7273 | 2017-01-11 |
| 1043767940 | Southcentral Foundation | Dentist | 11495 N. Callison Street, Sutton, AK 99674 | 2016-09-08 |
| Find all providers with the same taxonomy | ||||
| City | NORTH POLE |
| Zip Code | 99705 |
Please comment or provide details below to improve the information on GAMALIEL I. RODRIGUEZ, DDS, PC.
| 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.