Provider Demographics
NPI:1902573801
Name:HOWARD, KRISTEN JADE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:JADE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 642
Mailing Address - Street 2:
Mailing Address - City:BARROW
Mailing Address - State:AK
Mailing Address - Zip Code:99723-0642
Mailing Address - Country:US
Mailing Address - Phone:931-273-5100
Mailing Address - Fax:
Practice Address - Street 1:7000 UULA ST.
Practice Address - Street 2:
Practice Address - City:UTQIAGVIK
Practice Address - State:AK
Practice Address - Zip Code:99723-0029
Practice Address - Country:US
Practice Address - Phone:907-852-9221
Practice Address - Fax:907-852-9297
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK180991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist