STEPHEN H SUTLEY D.D.S. NPI 1124030085

NPI Information

NPI: 1124030085
Provider Name: STEPHEN H SUTLEY, D.D.S.
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
1275 SADLER WAY
SUITE 202
FAIRBANKS, AK
ZIP 99701
Phone: (907) 452-4101
Get Directions

Stephen H Sutley, D.D.S. is an oral and maxillofacial surgery dentist in Fairbanks, AK. The provider is 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. Stephen H Sutley, D.D.S. NPI is 1124030085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1275 SADLER WAY
SUITE 202
FAIRBANKS, AK
ZIP 99701-171
Phone: (907) 452-4101
Fax: (907) 452-4102

The NPI 1124030085 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/12/2006 and was last updated on 12/27/2018.

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	204E00000X	Oral & Maxillofacial Surgery		9881	KENTUCKY	No
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	106	ALASKA	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	DD441	MEDICAID	ALASKA
2	BS4634968	OTHER	ALASKA	DEA

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: 11/14/2023

NPI Synchronization or Removal

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