Provider Demographics
NPI:1467834424
Name:NEWMAN, ANDREW KEITH (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:KEITH
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12350 INDUSTRY WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-4301
Mailing Address - Country:US
Mailing Address - Phone:907-345-7722
Mailing Address - Fax:907-345-6734
Practice Address - Street 1:12350 INDUSTRY WAY STE 210
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-4301
Practice Address - Country:US
Practice Address - Phone:907-345-7722
Practice Address - Fax:907-345-6734
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1005331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice