Dr. Derick Jack Sovereign is a Wasilla, Alaska based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Derick Jack Sovereign is
224623 for Dentistry in Alaska. His current practice location is
3765 E Blue Lupine Dr Ste A, Wasilla. Patients can reach him at
480-341-0791.
Dr. Derick Jack Sovereign is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Derick Jack Sovereign speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Derick Jack Sovereign |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 3765 E Blue Lupine Dr Ste A, Wasilla,
Alaska, 99654-8417 |
| Phone: | 480-341-0791 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1245073287 |
| NPI Enumeration Date: | 17 Jun, 2024 |
| NPI Last Update On: | 17 Jun, 2024 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Derick Jack Sovereign are as mentioned below.
| License Number | Specialization | State | Status | |
| 224623 | Dentistry | Alaska | Primary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 3765 E Blue Lupine Dr Ste A,
Wasilla, Alaska |
| Zip: | 99654-8417 |
| Phone Number: | 480-341-0791 |
Patients can reach Dr. Derick Jack Sovereign at
3765 E Blue Lupine Dr Ste A, Wasilla, Alaska or can
call to book an appointment on 480-341-0791.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.