DR. PHYLLIS LYNN PENDERGRAST DMD
NPI 1457765471
Dentist in Fairbanks, AK

Q: What is Phyllis Pendergrast's NPI number?

The NPI number for Phyllis Pendergrast is 1457765471. It was assigned to this individual provider in the NPPES registry on June 18, 2014. The provider is also known as Miss Phyllis Lynn Everhardt.

Q: What is Phyllis Pendergrast's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since June 18, 2014PECOS Enrolled

3539 THOMAS ST, FAIRBANKS, AK 99709(907) 452-7041(907) 451-7166 Get Directions Write a Review

NPPES record last updated: June 26, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Phyllis Lynn Pendergrast Dmd NPPES

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

DR. PHYLLIS LYNN PENDERGRAST DMD (NPI 1457765471) is an individual dentist in Fairbanks, Alaska, licensed in Alaska (0477) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457765471

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. PHYLLIS LYNN PENDERGRASTCredential: DMD

Location Address3539 THOMAS STFairbanks, AK 99709

Mailing Address3539 Thomas StFairbanks, AK 99709 · (907) 452-7041 · Fax (907) 451-7166

Phone(907) 452-7041

Fax(907) 451-7166

Sole ProprietorNo

Enumeration DateJune 18, 2014

Last NPPES UpdateJune 26, 2014

✔ NPI 1457765471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in AK · 0477

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

3539 THOMAS ST, Fairbanks, AK 99709

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Other Names 1

Other Name (5)Miss Phyllis Lynn Everhardt

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Phyllis Lynn Pendergrast Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99709 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$111.57 typical visit price

range $71.33 – $222.64

Typical copayment $27.89 (range $17.83 – $55.66)

Most-billed visit code 99203

Established Patient

$90.40 typical visit price

range $21.84 – $181.48

Typical copayment $22.60 (range $5.46 – $45.37)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

DR. HANNAH SUMMERFELT DMD

Dentist (General Practice)

3539 THOMAS ST
FAIRBANKS, AK 99709

Fairbanks North Star Borough (907) 452-7041

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phyllis Pendergrast's NPI number?

The NPI number for Phyllis Pendergrast is 1457765471. It was assigned to this individual provider in the NPPES registry on June 18, 2014. The provider is also known as Miss Phyllis Lynn Everhardt.

Where is Phyllis Pendergrast located?

Phyllis Pendergrast practices at 3539 Thomas St, Fairbanks, AK 99709. The listed phone number is (907) 452-7041.

What is Phyllis Pendergrast's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Phyllis Pendergrast enrolled in Medicare?

Yes. Phyllis Pendergrast is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Phyllis Pendergrast was last updated on June 26, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.