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EVERGREEN DENTAL, LLC
NPI 1518574052
Dentist in Palmer, AK

Active since September 29, 2020
125 W EVERGREEN AVE STE 204, PALMER, AK 99645(907) 531-3477 Get Directions Write a Review

NPPES record last updated: September 29, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Evergreen Dental, Llc NPPES

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

EVERGREEN DENTAL, LLC (NPI 1518574052) is a healthcare organization registered as a dentist in Palmer, Alaska and active in the NPI registry since September 2020. The organization lists Rachael Fetuao Middleton, Chief Operations Officer, as its authorized official.

NPPES Registry Identity

NPI1518574052
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameEVERGREEN DENTAL, LLC
Location Address125 W EVERGREEN AVE STE 204Palmer, AK 99645-6908
Mailing Address125 W Evergreen Ave Ste 204Palmer, AK 99645-6908 · (907) 531-3477
Phone(907) 531-3477
Organization SubpartNo
Authorized OfficialRachael Fetuao MiddletonChief Operations Officer · (907) 276-4537
Enumeration DateSeptember 29, 2020
NPPES CertifiedSeptember 29, 2020
✔ NPI 1518574052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
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.
125 W EVERGREEN AVE STE 204, Palmer, AK 99645
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Other Identifiers 2

Medicaid1922430040AK
Medicaid1417158080AK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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. HUNTER MAXWELL PAUL DDS
Dentist (General Practice)
125 W EVERGREEN AVE STE 204
PALMER, AK 99645
Matanuska-Susitna Borough (907) 531-3477

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 Evergreen Dental, LLC's NPI number?

The NPI number for Evergreen Dental, LLC is 1518574052. It was assigned to this organization in the NPPES registry on September 29, 2020.

Where is Evergreen Dental, LLC located?

Evergreen Dental, LLC is located at 125 W Evergreen Ave Ste 204, Palmer, AK 99645. The listed phone number is (907) 531-3477.

What is Evergreen Dental, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Evergreen Dental, LLC was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.