FOUR CORNERS DENTAL GROUP FAIRBANKS (NPI# 1710310073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710310073 |
| Entity Type | Organization |
| Organization Name | FOUR CORNERS DENTAL GROUP FAIRBANKS |
| Practice Address |
3487 Airport Way Fairbanks AK 99709-4761 |
| Practice Telephone | 9074797771 |
| Practice Fax Number | 9074797772 |
| Mailing Telephone | 9074797771 |
| Mailing Fax Number | 9074797772 |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2013-08-09 |
| Authorized Official Name | DR. SHANE D RHOTON (DENTIST) |
| Authorized Official Telephone | 9074797771 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1262 | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DD0143 | 05 |
| Street Address |
3487 AIRPORT WAY |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-4761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588965792 | Gentry Toone | Dentist | 3487 Airport Way, Fairbanks, AK 99709-4761 | 2010-11-04 |
| 1588141220 | Tanner Douglas Zylstra | Dentist | 3487 Airport Way, Fairbanks, AK 99709-4761 | 2018-07-25 |
| 1871943258 | Andrew William Anderson | Dentist | 3487 Airport Way, Fairbanks, AK 99709-4761 | 2016-06-16 |
| 1518305176 | Ernest Nathaniel Sorensen | Dentist | 3487 Airport Way, Fairbanks, AK 99709-4761 | 2013-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| 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 |
|---|---|---|---|---|
| 1760034524 | Erin Winters | Dentist | 3706 Swenson Ave, Fairbanks, AK 99709-4643 | 2019-07-11 |
| 1790132496 | M Paige Dda & Jm Bressler Dds At Fairbanks LLC | Dentist | 503 14th Ave, Fairbanks, AK 99701-6236 | 2016-05-23 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1326362344 | Daniel M. Bergeron, D.d.s., P.C. | Dentist | 3112 Airport Way Ste 2, Fairbanks, AK 99709-4773 | 2010-03-19 |
| 1447486402 | University Dental Center | Dentist | 570 University Ave Ste A, Fairbanks, AK 99709-3641 | 2009-06-04 |
| 1659563757 | David Lee Sulkosky | Dentist | 1325 Wake Forest Way, Fairbanks, AK 99709-3224 | 2007-08-13 |
| 1891904009 | Elias C O'donoghue | Dentist | 1005 Danby St, Fairbanks, AK 99701-4372 | 2007-05-22 |
| 1114140548 | Michael M. Hostager | Dentist | 2136 Airport Way Ste 1, Fairbanks, AK 99701-4014 | 2007-04-11 |
| 1265569867 | Evan L. Wheeler | Dentist | 3691 Cameron St, Suite 101, Fairbanks, AK 99709-3843 | 2007-02-28 |
| 1649315227 | Ryle August Radke IIi | Dentist | 2136 Airport Way, Suite 1, Fairbanks, AK 99701 | 2007-02-21 |
| Find all providers in FAIRBANKS | ||||
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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.