PETE B HIGGINS DDS LLC NPI 1609055029

NPI Information

NPI: 1609055029
Provider Name: PETE B HIGGINS DDS LLC

Doing Business As: FOUR CORNERS DENTAL GROUP

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4001 GEIST RD STE 3
FAIRBANKS, AK
ZIP 99709
Phone: (907) 479-7771
Get Directions

PETE B HIGGINS DDS LLC is a dental clinic center in Fairbanks, AK. PETE B HIGGINS DDS LLC NPI is 1609055029. The provider is registered as an organization entity type.
The provider Is Doing Business As Four Corners Dental Group.

The provider's business location address is:

4001 GEIST RD STE 3
FAIRBANKS, AK
ZIP 99709-569
Phone: (907) 479-7771
Fax: (907) 479-7772

The provider's authorized official is Pete B. Higgins .
The authorized official title is Managing Member and has the following contact phone number (907) 479-7771.

The enumeration date for this NPI number is 11/1/2007 and was last updated on 11/1/2007.

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	1012	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	DD10121	MEDICAID	ALASKA
2	DD10122	MEDICAID	ALASKA
3	1568540946	OTHER		INDIVIDUAL NPI

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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