JACK B DUCLOS (NPI# 1518187210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518187210 |
| Entity Type | Individual |
| Full Name | JACK B DUCLOS |
| Credential | D.D.S, M.S. |
| Practice Address |
1836 W Northern Lights Blvd Anchorage AK 99517-3342 |
| Practice Telephone | 9072723200 |
| Mailing Telephone | 9072723200 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
871 | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DD0871 | 05 |
| Street Address |
1836 W NORTHERN LIGHTS BLVD |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99517-3342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871905679 | Luminary LLC | Massage Therapist | 1838 W. Northern Lights, Anchorage, AK 99517 | 2014-05-28 |
| 1447595129 | Antonina Ivanovna Shangraw | Behavioral Analyst | 2425 Captain Cook Dr, Anchorage, AK 99517 | 2012-12-06 |
| 1407000755 | James N. Duchanin | Physician Assistant | 3105 Lakeshore Dr., Bldg A, Ste 101, Anchorage, AK 99517 | 2008-11-13 |
| 1720290786 | Turnagain Foster Home | Assisted Living Facility | 2812 West 29th Ave, Anchorage, AK 99517 | 2007-05-04 |
| 1124244306 | Turnagain Foster Home | Taxi | 2900 West 29th Ave, Anchorage, AK 99517 | 2007-04-17 |
| 1497825798 | Scott Paul Mackie | Internal Medicine | 3710 Woodland Road, Suite 1100, Anchorage, AK 99517 | 2006-11-08 |
| 1629046446 | Ana Verzone | Nurse Practitioner | 3740 Clay Products Dr., Anchorage, AK 99517 | 2006-03-08 |
| 1740897503 | Far North Urology & Research PC | Urology | 2120 Sonstrom Dr, Anchorage, AK 99517-1018 | 2020-09-25 |
| 1376697011 | Celia Foley | Speech-Language Pathologist | 2515 Telequana Dr, Anchorage, AK 99517-1028 | 2007-01-22 |
| 1730122946 | Daryl A Young | Nurse Practitioner | 3611 Knik Avenue, Anchorage, AK 99517-1045 | 2006-06-14 |
| Find all providers in zip 99517 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059438 | Shannon Candid Alaska, P.C. | Dentist | 721 Depot Dr, Anchorage, AK 99501-1615 | 2020-09-23 |
| 1679697924 | Ronald I Glaeser | Dentist | 3708 Rhone Cir, Anchorage, AK 99508-5051 | 2007-03-19 |
| 1194864025 | Richard L. Day | Dentist | 10998 O'malley Centre Dr., Suite A, Anchorage, AK 99515 | 2007-02-06 |
| 1548321995 | Jeffrey W Symonds | Dentist | 1000 Omalley Road, Suite 105, Anchorage, AK 99515 | 2006-12-12 |
| 1902815798 | Michael Leo Koropp | Dentist | 2700 W Dimond Blvd, Anchorage, AK 99502-1603 | 2006-08-08 |
| 1629319132 | Kenneth M Eberle | Dentist | 3909 Arctic Blvd Ste 202, Anchorage, AK 99503-5769 | 2013-03-07 |
| 1356609192 | John Joseph Murray Jr. | Dentist | 12350 Industry Way, Suite 205, Anchorage, AK 99515 | 2012-04-30 |
| 1023267796 | Keith C Coombs | Dentist | 3708 Rhone Cir, Anchorage, AK 99508-5051 | 2008-09-17 |
| 1598957052 | Rebecca V Neslund | Dentist | 4201 Tudor Centre Dr, Suite 320, Anchorage, AK 99508-5904 | 2007-08-17 |
| 1619096203 | Derek N Priebe | Dentist | 3401 Denali St, 203, Anchorage, AK 99503-4034 | 2007-03-28 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.