MEDICARE: GLACIER DENTAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1239	AK
2	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093042194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLACIER DENTAL, LLC

Provider Business Mailing Address
First Line	:	8840 OLD SEWARD HIGHWAY, #F
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-2000
Country	:	US
Telephone Number	:	907-222-6000
Fax Number	:	907-333-3390

Provider Business Practice Location Address
First Line	:	2421 E TUDOR RD
Second Line	:	SUITE 101
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1166
Country	:	US
Telephone Number	:	907-222-6000
Fax Number	:	907-333-3390

Authorized Official
Title or Position	:	CEO
Name	:	DR. JOSHUA JEON
Credential	:	DDS
Telephone Number	:	907-222-6000

Provider Enumeration Date	:	11/10/2009
Last Update Date	:	01/11/2022

Similar Medicare Providers

1811348824 — MS. JENNIFER LANDRETH HUNT AGPCNP
Practice Location Address:

2421 E TUDOR RD STE 103
ANCHORAGE, AK
99507-1166

Practice Phone: 907-770-5864
Practice Fax: 907-770-5868

1073500302 — GREGORY NEAL CAGLE CRNP
Practice Location Address:

2421 E TUDOR RD STE 108
ANCHORAGE, AK
99507-1166

Practice Phone: 877-522-1275
Practice Fax: 833-888-7145

1801808050 — SLEEP CLINICS OF AMERICA LLC
Practice Location Address:

2421 E TUDOR RD STE 102
ANCHORAGE, AK
99507-1166

Practice Phone: 907-677-8889
Practice Fax: 907-677-8886

1659595387 — MR. RODNEY SLOOP GORDON R.PH.
Practice Location Address:

2421 E TUDOR RD , SUITE #107
ANCHORAGE, AK
99507-1166

Practice Phone: 907-561-2421
Practice Fax: 907-868-5113

1609067339 — NICOLE CURRY PHARMD
Practice Location Address:

2421 E TUDOR RD STE 107
ANCHORAGE, AK
99507-1166

Practice Phone: 907-561-2421
Practice Fax: 907-868-5154

1457580136 — SLEEP CENTERS OF ALASKA
Practice Location Address:

2421 E TUDOR RD STE 102
ANCHORAGE, AK
99507-1166

Practice Phone: 907-677-8889
Practice Fax: 907-677-8886

Directions to “GLACIER DENTAL, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.