CHRISTOPHER GREG ROSENVALL (NPI# 1891080776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891080776 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER GREG ROSENVALL |
| Credential | D.D.S. |
| Practice Address |
12641 Old Glenn Hwy Ste 203 Eagle River AK 99577 |
| Mailing Address |
12641 Old Glenn Hwy Ste 203 Eagle River AK 99577-7040 |
| Practice Telephone | 9076225437 |
| Mailing Telephone | 9076225437 |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2019-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 30-023455 | OH | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DEND1484 | AK | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
32861 | TX | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
1484 | AK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 3767600 | 05 | |
| AK | 1583802 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12641 Old Glenn Hwy Ste 203, Eagle River, AK 99577 | 9076225437 | |
| 2803 N Loy Lake Rd, Sherman, TX 750901726 | 9038922246 | |
| 3470 E Meridian Park Loop, Wasilla, AK 996547294 | 9073738684 | 9073738465 |
| Street Address |
12641 OLD GLENN HWY STE 203 |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213128 | Bitesize Pediatric Dentistry, LLC | Dentist | 44539 Sterling Hwy Ste 208, Soldotna, AK 99669-7960 | 2020-10-20 |
| 1093326308 | Molar Bear Pediatric Dentistry LLC | Dentist | 609 S Knik Goose Bay Rd Ste D, Wasilla, AK 99654-8079 | 2020-08-11 |
| 1083251078 | Alison Walsh, LLC | Dentist | 2601 Boniface Pkwy Ste 2, Anchorage, AK 99504-3144 | 2019-12-09 |
| 1124673165 | Bitesize Pediatric Dentistry, LLC | Dentist | 9138 Arlon St Ste A2, Anchorage, AK 99507-3876 | 2019-08-06 |
| 1528541752 | Todd C Miles LLC Dba Delaney Park Dental | Dentist | 880 N St Ste 301, Anchorage, AK 99501-3276 | 2018-09-13 |
| 1831677814 | Kelly Maixner Dmd LLC Dba Wee Care Pediatric Dentistry | Dentist | 1001 E Usa Cir Ste B, Wasilla, AK 99654-7198 | 2018-08-01 |
| 1487171088 | Acd, LLC | Dentist | 3340 Providence Dr., Suite 552, Anchorage, AK 99508 | 2017-08-24 |
| 1447619853 | Dr. K's Pediatric Dentistry | Dentist | 1050 S Cobb St Unit A, Palmer, AK 99645-6916 | 2016-02-12 |
| 1730591298 | Easte Warnick | Dentist | 3818 Westminster Way, Anchorage, AK 99508-4834 | 2014-06-02 |
| 1497166565 | Kristina Rabatin | Dentist | 4705 Piper St, Unit 1, Anchorage, AK 99507-1530 | 2014-05-12 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
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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.