Fairbanks Dental Specialists, LLC
NPI 1164291589ActiveOrganization· Dentist, Endodontics· Fairbanks, AK
Dentist, Endodontics in Fairbanks, Alaska, registered in NPPES in December 2023, part of Spruce Roots Family Dentistry, LLC. The authorized official on file is Chris Willis, Business Manager.
Overview
| NPI | 1164291589 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Spruce Roots Family Dentistry, LLC |
| NPI issued | Dec 27, 2023 |
| Last updated in NPPES | Dec 27, 2023 |
| Certified by provider | Dec 27, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Endodontics Primary | 1223E0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other endodontists in Fairbanks
- 1528524733
- 1508921925