Provider Demographics
NPI:1346220878
Name:CIN, BRIAN DENNIS (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DENNIS
Last Name:CIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 DEBARR RD
Mailing Address - Street 2:STE 1C
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-5200
Mailing Address - Country:US
Mailing Address - Phone:907-333-6040
Mailing Address - Fax:907-333-6619
Practice Address - Street 1:6901 DEBARR RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1806
Practice Address - Country:US
Practice Address - Phone:907-333-6040
Practice Address - Fax:907-333-6619
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK161478OtherMEDICARE NUMBER
AKOD68841Medicaid
AKOD68841Medicaid