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SOUTHCENTRAL FOUNDATION NPI 1225618481


NPI Information

NPI: 1225618481
Provider Name: SOUTHCENTRAL FOUNDATION
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
4441 DIPLOMACY DRIVE
CHILDREN'S DENTAL CLINIC
ANCHORAGE, AK
ZIP 99508
Phone: (907) 317-6070
Get Directions

SOUTHCENTRAL FOUNDATION is a general practice dentist in Anchorage, AK. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SOUTHCENTRAL FOUNDATION NPI is 1225618481. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4441 DIPLOMACY DRIVE
CHILDREN'S DENTAL CLINIC
ANCHORAGE, AK
ZIP 99508-910
Phone: (907) 317-6070
Fax: (817) 977-4688

The provider's authorized official is Kathryn Suzanne Miller .
The authorized official title is Patient Accounts Manager- Dental and has the following contact phone number (907) 317-6070.

The enumeration date for this NPI number is 4/12/2021 and was last updated on 4/12/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes
21223P0221XDentistPediatric DentistryNo
31223X0400XDentistOrthodontics and Dentofacial OrthopedicsNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11685411MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.