Provider Demographics
NPI:1326920406
Name:ALDOUS, MARINA NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:NICOLE
Last Name:ALDOUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5630 GATE KEEPER AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3118
Mailing Address - Country:US
Mailing Address - Phone:907-602-2801
Mailing Address - Fax:
Practice Address - Street 1:2000 ABBOTT RD STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3878
Practice Address - Country:US
Practice Address - Phone:907-349-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK242059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist