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DENALI PRIMARY CARE
NPI 1710664966
Pediatrics in Fairbanks, AK

Active since June 29, 2023CLIA 02D2296697 · Waiver
1919 LATHROP ST STE 204, FAIRBANKS, AK 99701(907) 687-6226 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Denali Primary Care NPPES

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

DENALI PRIMARY CARE (NPI 1710664966) is a healthcare organization registered as a pediatrics in Fairbanks, Alaska and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through January 3, 2028 and lists Manal Darwish Shihadeh, Physician, as its authorized official.

NPPES Registry Identity

NPI1710664966
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameDENALI PRIMARY CARE
Location Address1919 LATHROP ST STE 204Fairbanks, AK 99701-5942
Mailing AddressPo Box 81336Fairbanks, AK 99708-1336 · (907) 687-6226
Phone(907) 687-6226
Organization SubpartNo
Authorized OfficialManal Darwish ShihadehPhysician · (907) 687-6226
Enumeration DateJune 29, 2023
Last NPPES UpdateMarch 1, 2024
NPPES CertifiedMarch 1, 2024
✔ NPI 1710664966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1919 LATHROP ST STE 204, Fairbanks, AK 99701
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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 of Waiver 02D2296697

Denali Primary Care, LLC · Fairbanks, AK
Active · expires Jan 3, 2028
CLIA Number02D2296697
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorDr. Manal D. Shihadeh
Laboratory Phone(907) 374-2637
Laboratory LocationDenali Primary Care, LLC1919 Lathrop St, Ste 204, Fairbanks, AK 99701
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MANAL SHIHADEH M.D.
Pediatrics
1919 LATHROP ST STE 204
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-2637
FAIRBANKS SURGERY, LLC
Surgery
1919 LATHROP ST STE 204
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 452-8151
WILLIAM MONTANO, M.D., INC.
Surgery
1919 LATHROP ST STE 204
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 452-8151

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 Denali Primary Care's NPI number?

The NPI number for Denali Primary Care is 1710664966. It was assigned to this organization in the NPPES registry on June 29, 2023.

Where is Denali Primary Care located?

Denali Primary Care is located at 1919 Lathrop St Ste 204, Fairbanks, AK 99701. The listed phone number is (907) 687-6226.

What is Denali Primary Care's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Denali Primary Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 02D2296697) is associated with this NPI, valid through January 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Denali Primary Care accept?

Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Denali Primary Care as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Denali Primary Care was last updated on March 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.