EAGLE SUMMIT DENTAL GROUP (NPI# 1629214705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629214705 |
| Entity Type | Organization |
| Organization Name | EAGLE SUMMIT DENTAL GROUP |
| Other Organization Name | MICHAEL SANDERS DMD PC |
| Practice Address |
13015 Old Glenn Hwy #200 Eagle River AK 99577 |
| Mailing Address |
13015 Old Glenn Hwy #200 Eagle River AK 99577-8080 |
| Practice Telephone | 9076948234 |
| Practice Fax Number | 9076978225 |
| Mailing Telephone | 9076948234 |
| Mailing Fax Number | 9076978225 |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2014-11-25 |
| Authorized Official Name | DR. MICHAEL ROLAND SANDERS (PRESIDENT) |
| Authorized Official Telephone | 9076948234 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 1086 | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | STATE LICENSE | 1086 | 01 |
| Other Name | Type Code |
|---|---|
| Michael Sanders DMD PC | Former Legal Business Name - Organization |
| Street Address |
13015 OLD GLENN HWY #200 |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538387790 | Michael R Sanders | Dentist | 13015 Old Glenn Hwy, #200, Eagle River, AK 99577 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003280991 | Lookhart Dental, LLC | Dentist | 18932 Twenty Grand Rd, Eagle River, AK 99577-8397 | 2015-11-16 |
| 1023440948 | Walter Samuel Langkau | Dentist | 4254 State Highway 70 E, Eagle River, WI 54521-9407 | 2013-08-01 |
| 1649535865 | Denis S. Corral, D.d.s., P.C. | Dentist | 11901 Business Blvd., #201, Eagle River, AK 99577-7701 | 2012-07-13 |
| 1326325879 | James M Yassick Dds PC | Dentist | 13012 Old Glenn Hwy Ste 102, Eagle River, AK 99577-7568 | 2011-11-11 |
| 1891080776 | Christopher Greg Rosenvall | Dentist | 12641 Old Glenn Hwy Ste 203, Eagle River, AK 99577 | 2011-06-18 |
| 1245356245 | Enoch Nathan Ross | Dentist | 12641 Old Glenn Hwy, Suite 104, Eagle River, AK 99577-7039 | 2007-03-21 |
| 1518004498 | Denis Salvador Corral | Dentist | 11901 Business Blvd, Suite 201, Eagle River, AK 99577-7726 | 2007-01-31 |
| 1124365622 | Allen Dental Group LLC | Dentist | 17101 Snowmobile Ln, Suite 107, Eagle River, AK 99577-7043 | 2013-01-04 |
| 1043413172 | James M Yassick | Dentist | 13012 Old Glenn Hwy, Suite #102, Eagle River, AK 99577-7561 | 2007-06-06 |
| 1952325193 | Alfred M Land IIi | Dentist | 10928 Eagle River Rd, Suite 250, Eagle River, AK 99577-8038 | 2006-07-27 |
| Find all providers in EAGLE RIVER | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
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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.