Provider Demographics
NPI:1134595804
Name:HILL, RICHARD BARDWELL (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BARDWELL
Last Name:HILL
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 1:2020 ABBOTT RD STE 5
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-4624
Mailing Address - Country:US
Mailing Address - Phone:907-313-8918
Mailing Address - Fax:907-206-4794
Practice Address - Street 1:2020 ABBOTT RD STE 5
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4624
Practice Address - Country:US
Practice Address - Phone:907-313-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0404711223G0001X, 1223P0300X
AK1459631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice