Provider Demographics
NPI:1982675609
Name:LOVEJOY, ELLE KIMBERLY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELLE KIMBERLY
Middle Name:
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:L. KIMBERLY
Other - Middle Name:
Other - Last Name:LOVEJOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:292 SNOWY OWL LANE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99712
Mailing Address - Country:US
Mailing Address - Phone:907-687-4119
Mailing Address - Fax:907-456-8101
Practice Address - Street 1:607 OLD STEESE HWY STE C
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3163
Practice Address - Country:US
Practice Address - Phone:907-452-8251
Practice Address - Fax:907-459-3837
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDD9399Medicaid