DR. THEOBOLD GREGORY REMAKLUS (NPI# 1912166240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912166240 |
| Entity Type | Individual |
| Full Name | DR. THEOBOLD GREGORY REMAKLUS |
| Credential | D.M.D. |
| Practice Address |
4200 Lake Otis Pkwy Suite 102 Anchorage AK 99508-5226 |
| Practice Telephone | 9075611884 |
| Practice Fax Number | 9075621883 |
| Mailing Telephone | 9075611884 |
| Mailing Fax Number | 9075621883 |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
AA042 | AK | Dental Providers |
| Street Address |
4200 LAKE OTIS PKWY SUITE 102 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487645297 | Susan L Donohue | Nurse Practitioner | 4200 Lake Otis Pkwy, Suite 202, Anchorage, AK 99508-5215 | 2005-11-01 |
| 1669861753 | Anchorage Dental Care, LLC | Dentist | 4200 Lake Otis Pkwy, 201, Anchorage, AK 99508-5226 | 2015-01-13 |
| 1427454180 | Anna Berit Alcorn | Hearing Instrument Specialist | 4200 Lake Otis Pkwy, Suite 302, Anchorage, AK 99508-5226 | 2014-11-07 |
| 1801228788 | Heide Provencher | Nurse Practitioner | 4200 Lake Otis Pkwy, Anchorage, AK 99508-5226 | 2013-08-02 |
| 1205176245 | Ravenwood Healthcare LLC | Nurse Practitioner | 4200 Lake Otis Pkwy, 202, Anchorage, AK 99508-5226 | 2013-02-28 |
| 1376838714 | Christy Mary Jen | Dentist | 4200 Lake Otis Pkwy, Anchorage, AK 99508 | 2011-06-14 |
| 1417267337 | Anchorage Pediatric Dentistry, Inc | Dentist | 4200 Lake Otis Pkwy, Suite 102, Anchorage, AK 99508-5226 | 2010-10-13 |
| 1366764359 | Stephen G. Howard, Dds, Inc | Dentist | 4200 Lake Otis Pkwy, Suite #201, Anchorage, AK 99508-5226 | 2010-02-18 |
| 1699952358 | Alaska Family Wellness Center Inc | Exclusive Provider Organization | 4200 Lake Otis Pkwy, Suite 304, Anchorage, AK 99508-5226 | 2008-01-24 |
| 1417147216 | Suzanne Lelevier | Audiologist | 4200 Lake Otis Pkwy, Suite 302, Anchorage, AK 99508-5226 | 2007-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164432548 | Douglas A. Boyce | Dentist | 4001 Laurel St Ste 205, Anchorage, AK 99508-5300 | 2006-08-09 |
| 1003278698 | Thomas Nelson Wanat IIi | Dentist | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2016-03-23 |
| 1588811426 | Robert Holt Jr. | Dentist | 4120 Laurel St, Suite 202, Anchorage, AK 99508-5592 | 2008-08-22 |
| 1750596425 | Charles A. Powell, Dds, Ms, PC | Dentist | 3340 Providence Dr, Ste 560, Anchorage, AK 99508-4616 | 2007-05-14 |
| 1154544633 | Robert Matthews, D.d.s., A.p.c. | Dentist | 9138 Arlon St, Suite B3, Anchorage, AK 99507-3822 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669455945 | Jeffrey David Rogers | Dentist | 1305 - 21st Avenue, Suite 204, Fairbanks, AK 99701 | 2005-11-21 |
| 1972593747 | Robert Lewis Holmes | Dentist | 1060 Gaffney Rd #7500, Us Army Dental Activity, Attn: Credentials Coordinator, Fort Wainwright, AK 99703 | 2005-10-24 |
| 1053550400 | Melissa Marcella Webster | Dentist | 421 3rd St, Ste B, Fairbanks, AK 99701-3506 | 2009-02-09 |
| 1548323710 | Andrew Edward Stanya | Dentist | 1919 Lathrop St, Suite 210, Fairbanks, AK 99701-5930 | 2006-12-19 |
Please comment or provide details below to improve the information on DR. THEOBOLD GREGORY REMAKLUS.
| 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.