BRISTOL BAY AREA HEALTH CORPORATION (NPI# 1770782831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770782831 |
| Entity Type | Organization |
| Organization Name | BRISTOL BAY AREA HEALTH CORPORATION |
| Other Organization Name | DENTAL GROUP |
| Practice Address |
6000 Kanakanak Rd Dillingham AK 99576 |
| Mailing Address |
Po Box 130 Dillingham AK 99576-0130 |
| Practice Telephone | 9078425201 |
| Practice Fax Number | 9078429250 |
| Mailing Telephone | 9078425201 |
| Mailing Fax Number | 9078429250 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2013-04-04 |
| Authorized Official Name | ROBERT CLARK (CEO) |
| Authorized Official Telephone | 9078425201 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | GR0175 | 05 |
| Other Name | Type Code |
|---|---|
| DENTAL GROUP | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427119874 | Bristol Bay Area Health Corporation | Clinic/Center | Main Steet, Portage Creek, AK 99576 | 2006-12-12 |
| 1396292751 | Bristol Bay Area Health Corporation | Hearing Aid Equipment | 6000 Kanakanak Rd., Dillingham, AK 99576-0130 | 2016-09-02 |
| 1154551588 | Bristol Bay Area Health Corporation | Optometrist | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2009-07-20 |
| 1962688309 | Bristol Bay Area Health Corporation | General Acute Care Hospital | 6000 Kanakanak Rd, Dillingham, AK 99576-0130 | 2008-01-16 |
| 1497954556 | Bristol Bay Area Health Corporation | Case Management | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1689873739 | Bristol Bay Area Health Corporation | Family Medicine | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1972702025 | Bristol Bay Area Health Corporation | Family Medicine | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1295868289 | Bristol Bay Area Health Corporation | Community/Behavioral Health | 6000 Kanakanak Road, Dillingham, AK 99576 | 2007-03-13 |
| 1336272095 | Bristol Bay Area Health Corporation | Pharmacy | 6000 Kanakanak Road, Dillingham, AK 99576 | 2007-03-13 |
| 1114050911 | Bristol Bay Area Health Corporation | Substance Abuse Rehabilitation Facility | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2007-03-13 |
| Street Address |
6000 KANAKANAK RD |
| City | DILLINGHAM |
| State | AK |
| Zip Code | 99576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760465181 | Juliana Christine Montooth | Family Medicine | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2005-11-21 |
| 1861099285 | Sequoya Dionne Hayes | Social Worker | 6000 Kanakanak Rd, Dillingham, AK 99576-0130 | 2020-10-08 |
| 1366061442 | Zoe Ann Vitkus | Case Manager/Care Coordinator | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2020-04-09 |
| 1285270181 | Veronica Maldonado | Social Worker | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2019-11-26 |
| 1659912020 | Luke D Villnave | Case Manager/Care Coordinator | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2019-10-07 |
| 1477103612 | Angela Duke | Registered Nurse | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2019-09-19 |
| 1164082111 | Je' Saundra Michelle Acuavera | Registered Nurse | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2019-06-20 |
| 1457843138 | Kristin Melinda Walcott | Community Health Worker | 6000 Kanakanak Rd, Dillingham, AK 99576-0130 | 2018-05-30 |
| 1942714654 | Rebecca A Shangin | Community Health Worker | 6000 Kanakanak Rd, Chignik Lake Clinic, Dillingham, AK 99576-0130 | 2017-11-17 |
| 1740727668 | Tabitha Holm | Community Health Worker | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2017-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174016737 | Lake Road Dental LLC | Clinic/Center | 4622 Shannon Lake Rd, Dillingham, AK 99576 | 2018-06-08 |
| 1053837823 | Guardian Flight LLC | Ambulance | Beluga Bluffs Apt Block 26, Lot 5 Apt. 5 & 6, Dillingham, AK 99576 | 2017-08-14 |
| 1467820910 | Alicia Mahlow | Case Manager/Care Coordinator | 540 Gauthier Way, Dillingham, AK 99576 | 2015-09-14 |
| 1306100557 | Peter Tallman | Social Worker | 6000 Kanakanak, Dillingham, AK 99576 | 2012-07-02 |
| 1801079546 | Marrulut Eniit Assisted Living, Inc | Respite Care | 125 D Street, Dillingham, AK 99576 | 2007-12-17 |
| 1730393430 | City of Dillingham | Ambulance | 514 Main Street, Dillingham, AK 99576 | 2007-05-10 |
| 1023132792 | City of Dillingham Senior Center | Non-emergency Medical Transport (VAN) | 515 East 1st Ave, Dillingham, AK 99576 | 2007-03-19 |
| 1912037037 | Hope Community Resources Inc | Day Training, Developmentally Disabled Services | Chog Center Main Street, Dillingham, AK 99576 | 2007-03-07 |
| 1427119874 | Bristol Bay Area Health Corporation | Clinic/Center | Main Steet, Portage Creek, AK 99576 | 2006-12-12 |
| 1396728614 | Joan Lucienne Junge | Nurse Practitioner | 1500 Kanakanak Rd, Dillingham, AK 99576 | 2005-11-21 |
| Find all providers in zip 99576 | ||||
| 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 |
|---|---|---|---|---|
| 1306056841 | James A Libby | Dentist | 4622 Shannon's Lake Road, Dillingham, AK 99576-0809 | 2007-05-23 |
| 1336396597 | Katie Burley | Dentist | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2008-08-19 |
| 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 | DILLINGHAM |
| Zip Code | 99576 |
Please comment or provide details below to improve the information on BRISTOL BAY AREA HEALTH CORPORATION.
| 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.