Provider Demographics
NPI:1154523587
Name:BIEDERMAN, PAUL A (DDS)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:BIEDERMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 W FIREWEED LN
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2003
Mailing Address - Country:US
Mailing Address - Phone:907-258-7060
Mailing Address - Fax:
Practice Address - Street 1:121 W FIREWEED LN
Practice Address - Street 2:SUITE 280
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2003
Practice Address - Country:US
Practice Address - Phone:907-258-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK005391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDD05391Medicaid