CHUN PIU MAN, INC. (NPI# 1871003863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871003863 |
| Entity Type | Organization |
| Organization Name | CHUN PIU MAN, INC. |
| Other Organization Name | EAGLE RIVER SMILES |
| Practice Address |
11431 Business Blvd Ste 5 Eagle River AK 99577-7754 |
| Practice Telephone | 9076962875 |
| Practice Fax Number | 9076962878 |
| Mailing Telephone | 9076962875 |
| Mailing Fax Number | 9076962878 |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |
| Authorized Official Name | CHUN PIU MAN (PRESIDENT) |
| Authorized Official Telephone | 9076932875 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
105454 | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1740685478 | 05 |
| Other Name | Type Code |
|---|---|
| Eagle River Smiles | Doing Business As Name - Organization |
| Street Address |
11431 BUSINESS BLVD STE 5 |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-7754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699950451 | Bryan J Enghirst | Dentist | 11431 Business Blvd Ste 5, Eagle River, AK 99577-7738 | 2007-12-28 |
| 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 | 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 |
|---|---|---|---|---|
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1669889689 | Bradley Camp | Dentist | 415 East Wall Street, Eagle River, WI 54521 | 2014-07-22 |
| 1063760593 | Courtney Burrill | Dentist | 17101 Snowmobile Ln Ste 107, Eagle River, AK 99577-7043 | 2012-08-15 |
| 1790002335 | Brad Woodring | Dentist | 10928 Eagle River Rd Ste 105, Eagle River, AK 99577-8079 | 2010-04-21 |
| 1124254644 | Jason Potrykus | Dentist | 213 Railroad St, Eagle River, WI 54521-8139 | 2009-06-10 |
| 1508013319 | Neal Potrykus | Dentist | 213 N. Railroad St., Eagle River, WI 54521 | 2008-08-22 |
| 1699950451 | Bryan J Enghirst | Dentist | 11431 Business Blvd Ste 5, Eagle River, AK 99577-7738 | 2007-12-28 |
| 1891997185 | James V Penfield | Dentist | 12641 Old Glenn Hwy Suite 101, Eagle River, AK 99577 | 2007-05-31 |
| 1366654659 | Joseph Patrick Caterinichio | Dentist | 11723 Old Glenn Highway, Suite 213, Eagle River, AK 99577 | 2007-05-07 |
| 1538387790 | Michael R Sanders | Dentist | 13015 Old Glenn Hwy, #200, Eagle River, AK 99577 | 2007-04-23 |
| 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.