| Kevin M Easley DMD PC | |
|
330 E Tudor Rd Anchorage AK 99503-7369 | |
| (907) 248-0022 | |
| (907) 206-3905 |
| Full Name | Kevin M Easley DMD PC |
|---|---|
| Speciality | Dentist |
| Location | 330 E Tudor Rd, Anchorage, Alaska |
| Authorized Official Name and Position | Kevin M Easley (PRESIDENT) |
| Authorized Official Contact | 9072480022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin M Easley DMD PC 330 E Tudor Rd Anchorage AK 99503-7369 Ph: (907) 248-0022 | Kevin M Easley DMD PC 330 E Tudor Rd Anchorage AK 99503-7369 Ph: (907) 248-0022 |
| NPI Number | 1841533155 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/08/2025 |
| Medicare PECOS PAC ID | 2365685336 |
|---|---|
| Medicare Enrollment ID | O20130823001068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841533155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 994 (Alaska) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (NU) | Secondary |
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