IndividualActive
Kelly Bast, DDS
NPI 1740358753 · Oral and Maxillofacial Surgery (Dentist) · Fairbanks, AK
Provider details
- NPI number
- 1740358753
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- License
- 1188 (AK)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Practice location
3112 Airport Way Ste 1
Fairbanks, AK 99709-4768
Phone: (907) 452-1250
Approximate (ZIP-level) locationGet directions
Mailing address
3112 Airport Way Ste 1
Fairbanks, AK 99709-4768
Registry dates
- Enumerated
- 2006-11-30
- Last updated
- 2023-09-06
- Certified
- 2023-09-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.