KEGUTA DENTAL LLC NPI 1578999306

NPI Information

NPI: 1578999306
Provider Name: KEGUTA DENTAL LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
660 THIRD AVE STE C
BETHEL, AK
ZIP 99559
Phone: (907) 545-3996
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KEGUTA DENTAL LLC is a dental clinic center in Bethel, AK. KEGUTA DENTAL LLC NPI is 1578999306. The provider is registered as an organization entity type.

The provider's business location address is:

660 THIRD AVE STE C
BETHEL, AK
ZIP 99559-169
Phone: (907) 545-3996

The provider's authorized official is Edwin H Allgair .
The authorized official title is Dental Director/manager and has the following contact phone number (206) 419-0787.

The enumeration date for this NPI number is 9/25/2013 and was last updated on 8/20/2014.

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	261QD0000X	Clinic/Center	Dental	D997	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	1608341	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: 11/14/2023

NPI Synchronization or Removal

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