INTERIOR COMMUNITY HEALTH CENTER DENTAL PROG
NPI 1124244181
Clinic/Center - Dental in Fairbanks, AK

Q: What is Interior Community Health Center Dental Prog's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since April 18, 2007CLIA 02D0902300 · Microscopy

1606 23RD AVE, FAIRBANKS, AK 99701(907) 455-4567 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Interior Community Health Center Dental Prog NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTERIOR COMMUNITY HEALTH CENTER DENTAL PROG (NPI 1124244181) is a healthcare organization registered as a dental in Fairbanks, Alaska and active in the NPI registry since April 2007. The organization holds a CLIA Microscopy certificate valid through June 15, 2027 and lists Cheryl Kilgore, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1124244181

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameINTERIOR COMMUNITY HEALTH CENTER DENTAL PROG

Location Address1606 23RD AVEFairbanks, AK 99701-6407

Mailing Address1606 23rd AveFairbanks, AK 99701-6407 · (907) 455-4567

Phone(907) 455-4567

Organization SubpartNo

Authorized OfficialCheryl KilgoreExecutive Director · (907) 455-4567

Enumeration DateApril 18, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1124244181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

1606 23RD AVE, Fairbanks, AK 99701

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Other Identifiers 1

Other02-1810AK · Provider Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Alaska, Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 02D0902300

Interior Community Health Center · Fairbanks, AK

Active · expires Jun 15, 2027

CLIA Number02D0902300

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateJune 16, 2025

Certificate Expiration DateJune 15, 2027

Laboratory DirectorDr. Rebecca Taylor

Laboratory Phone(907) 455-4567

Laboratory LocationInterior Community Health Center1606 23rd Avenue, Fairbanks, AK 99701

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY W KILGORE D.M.D.

Dentist