OrganizationActive
The Villiage Store Inc
NPI 1659400596 · Optometrist · Fairbanks, AK
Provider details
- NPI number
- 1659400596
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- James Graves, President Owner(907) 474-8695
- License
- 97 (AK)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3455 Rewak Dr
Suite 102
Fairbanks, AK 99709
Phone: (907) 474-8695
Fax: (907) 474-8727
Street-level locationGet directions
Mailing address
3455 Rewak Dr
Fairbanks, AK 99709
Other names (DBA / former)
- Doing business as
- Fairbanks Optometric Center
Registry dates
- Enumerated
- 2007-03-05
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.