KODIAK ISLAND FAMILY DENTISTRY
NPI 1811568900
Clinic/Center - Dental in Kodiak, AK

Active since July 08, 2021
204 E REZANOF DR STE 201, KODIAK, AK 99615(907) 481-3567 Get Directions Write a Review

NPPES record last updated: July 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kodiak Island Family Dentistry NPPES

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

KODIAK ISLAND FAMILY DENTISTRY (NPI 1811568900) is a healthcare organization registered as a dental in Kodiak, Alaska and active in the NPI registry since July 2021. The organization lists Tabitha Leiva, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1811568900
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameKODIAK ISLAND FAMILY DENTISTRY
Location Address204 E REZANOF DR STE 201Kodiak, AK 99615-6379
Mailing Address204 E Rezanof Dr Ste 201Kodiak, AK 99615-6379 · (907) 481-3567
Organization SubpartNo
Authorized OfficialTabitha LeivaOffice Manager · (907) 481-3567
Enumeration DateJuly 8, 2021
NPPES CertifiedJuly 8, 2021
NPI 1811568900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
204 E REZANOF DR STE 201, Kodiak, AK 99615

Other Identifiers 3

Medicaid1437243326AK
Medicaid1326421850AK
Medicaid1639787021AK

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 Kodiak Island Family Dentistry's NPI number?

The NPI number for Kodiak Island Family Dentistry is 1811568900. It was assigned to this organization in the NPPES registry on July 8, 2021.

Where is Kodiak Island Family Dentistry located?

Kodiak Island Family Dentistry is located at 204 E Rezanof Dr Ste 201, Kodiak, AK 99615. The listed phone number is (907) 481-3567.

What is Kodiak Island Family Dentistry's specialty?

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

When was this NPI record last updated?

The NPPES record for Kodiak Island Family Dentistry was last updated on July 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.