DR. LEONARDO MANUEL RIOS-ANDERSEN (NPI# 1699735050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699735050 |
| Entity Type | Individual |
| Full Name | DR. LEONARDO MANUEL RIOS-ANDERSEN |
| Credential | D.M.D. |
| Practice Address |
12641 Old Glenn Hwy Ste 103 Eagle River AK 99577-7040 |
| Practice Telephone | 9077265600 |
| Practice Fax Number | 9077265602 |
| Mailing Telephone | 9077265600 |
| Mailing Fax Number | 9077265602 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DEND1448 | AK | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
02558 | PR | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5955 Zeamer Ave, Elmendorf Air Force Base, Anchorage, AK 995063702 | 9075805010 | 9075805022 |
| 12641 Old Glenn Hwy Ste 103, Eagle River, AK 995777040 | 9077265600 | 9077265602 |
| Street Address |
12641 OLD GLENN HWY STE 103 |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-7040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215437165 | Arctic Oral Surgery, LLC | Dentist | 12641 Old Glenn Hwy Ste 103, Eagle River, AK 99577 | 2018-02-16 |
| 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 | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215437165 | Arctic Oral Surgery, LLC | Dentist | 12641 Old Glenn Hwy Ste 103, Eagle River, AK 99577 | 2018-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215446042 | Frontier Oral & Maxillofacial Surgery LLC | Dentist | 3220 Providence Dr Ste E3-080, Anchorage, AK 99508-4657 | 2017-09-25 |
| 1235679515 | Matthew A Monaco Dds,llc | Dentist | 3465 E Meridian Park Loop, Suite A, Wasilla, AK 99654-7264 | 2017-03-06 |
| 1063710994 | Fairbanks Oral Surgery, LLC | Dentist | 12810 Glen Alps Rd, Anchorage, AK 99516-6956 | 2011-03-01 |
| 1760619118 | Bradley John Szutz | Dentist | 1200 Airport Heights Dr. Suite #265, Anchorage, AK 99508 | 2009-06-12 |
| 1689810707 | Alaska Oral Surgery Group, P.C. | Dentist | 1200 Airport Heights Dr Ste 265, Anchorage, AK 99508-2988 | 2008-12-18 |
| 1174709927 | Summit Oral Surgery LLC | Dentist | 1700 E Bogard Rd Ste B202, Wasilla, AK 99654-6570 | 2008-01-10 |
| 1023145026 | Sarah J Satow | Dentist | 114 Minnie St., Suite D, Fairbanks, AK 99701 | 2007-02-27 |
| 1861549909 | Richard H. Day | Dentist | 1700 Bogard Rd Bldg B Suite 202, Wasilla, AK 99654-6563 | 2007-01-04 |
| 1194745570 | David M. Edwards | Dentist | 3330 Windlass Cir, Anchorage, AK 99516-3438 | 2006-07-20 |
| 1225058977 | Ray A. Holloway | Dentist | 111 W 16th Ave, Suite 203, Anchorage, AK 99501-6206 | 2006-07-19 |
| Find all providers with the same taxonomy | ||||
| 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.