KODIAK AREA NATIVE ASSOCIATION
NPI 1205883907
Clinic/Center - Dental in Kodiak, AK
NPI Status: Active since May 28, 2006
Contact Information
3449 E REZANOF DR
KODIAK, AK
ZIP 99615
Phone: (907) 486-9800
Fax: (907) 486-9897
- Organization
- Clinic/Center
- Dental
- Accepts Insurance
- CLIA Number: 02D2136079
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-31-2027
About KODIAK AREA NATIVE ASSOCIATION
This page provides the complete NPI Profile along with additional information for Kodiak Area Native Association, a provider established in Kodiak, Alaska operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1205883907 assigned on May 2006. The practitioner's primary taxonomy code is 261QD0000X with license number 233103 (AK). The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mike Pfeffer (Ceo)
- NPI
- 1205883907
- Provider Name
- KODIAK AREA NATIVE ASSOCIATION
- Entity Type
- Organization
- Location Address
- 3449 E REZANOF DR KODIAK, AK 99615
- Location Phone
- (907) 486-9800
- Location Fax
- (907) 486-9897
- Mailing Address
- 3449 E REZANOF DR KODIAK, AK 99615
- Mailing Phone
- (907) 486-9800
- Mailing Fax
- (907) 486-9897
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-28-2006
- Last Update Date
- 02-15-2024
- Code Navigator
Location Map
Secondary Locations
- 2414 Mill Bay Rd
Kodiak, AK 99615
(907) 486-9800
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 233103
- License State
- AK
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1003903 | MEDICAID (05) | AK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 02D2136079
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 01, 2025
- Certificate Expiration Date
- August 31, 2027
- Laboratory Director
- DR. EVAN JONES
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Kodiak Area Native Association in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for KODIAK AREA NATIVE ASSOCIATION
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205883907, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
KODIAK, AK 99615
KODIAK, AK 99615
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205883907, enumerated as an "organization" on May 28, 2006.
The provider is located at 3449 E REZANOF DR KODIAK, AK 99615 and the phone number is (907) 486-9800.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska, Medicare. Please consult your insurance carrier or call the provider to verify.
