Unknown Individual – Periodontics, NPI 1912166240

Unknown Individual is a healthcare provider. based in Anchorage, Alaska. specializing in Periodontics. They hold a License No. AA042 (AK). The NPI Number for Unknown Individual is 1912166240

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1912166240
Phone
(907) 561-1884
Address
4200 LAKE OTIS PKWY
Deactivation Date
9 December 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4200, Lake Otis Parkway, Rogers Park, Anchorage, Alaska, 99508, United States

    SUITE 102

    ANCHORAGE, AK 995085226

    Phone: (907) 561-1884

    Fax: (907) 562-1883

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99508)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1912166240 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Periodontics. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Anchorage, Alaska for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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