KENAITZE INDIAN TRIBE NPI 1295972677

NPI Information

NPI: 1295972677
Provider Name: KENAITZE INDIAN TRIBE

Doing Business As: DENAINA DENTAL CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
508 UPLAND ST
KENAI, AK
ZIP 99611
Phone: (907) 335-7500
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KENAITZE INDIAN TRIBE is a federally qualified health center (fqhc) clinic center in Kenai, AK. KENAITZE INDIAN TRIBE NPI is 1295972677. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Denaina Dental Clinic.

The provider's business location address is:

508 UPLAND ST
KENAI, AK
ZIP 99611-026
Phone: (907) 335-7500
Fax: (907) 335-2155

The provider's authorized official is Christopher Koski .
The authorized official title is Director Of Health Systems and has the following contact phone number (907) 335-7557.

The CLIA number assigned to this NPI record is 02D0708909 - community clinic with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/7/2009 and was last updated on 2/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		IHS	ALASKA	No
2	261QD0000X	Clinic/Center	Dental			No
3	332800000X	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy				No
4	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	021855	OTHER	ALASKA	FQHC CERTIFICATION NUMBER
2	DDG	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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