Provider Demographics
NPI:1093874935
Name:DENTISTRY FOR CHILDREN, INC
Entity Type:Organization
Organization Name:DENTISTRY FOR CHILDREN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:PEDIATRIC DENTIST
Authorized Official - Phone:907-274-2525
Mailing Address - Street 1:880 N ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3276
Mailing Address - Country:US
Mailing Address - Phone:907-274-2525
Mailing Address - Fax:907-277-4725
Practice Address - Street 1:880 N ST STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3276
Practice Address - Country:US
Practice Address - Phone:907-274-2525
Practice Address - Fax:907-277-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK 4191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKAK 419OtherSTATE LICENSE #
AKDDO419Medicaid