SOUTHCENTRAL FOUNDATION NPI 1578010476

NPI Information

  • NPI: 1578010476
  • Provider Name: SOUTHCENTRAL FOUNDATION
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: NEWHALEN DENTAL CLINIC
  • Address: 102 FIREWEED LANE
    NEWHALEN, AK
    ZIP 99606
  • Phone: (907) 571-1231

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NPI Details

SOUTHCENTRAL FOUNDATION is a general practice dentist in Newhalen, 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 1578010476. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Newhalen Dental Clinic.

The provider's business location address is:

102 FIREWEED LANE
NEWHALEN, AK
ZIP 99606
Phone: (907) 571-1231
Fax: (907) 571-1551

The provider's authorized official is Kevin Gottlieb .
The authorized official title is Vice President and has the following contact phone number (907) 317-6070.

The enumeration date for this NPI number is 9/8/2016 and was last updated on 9/8/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice20467ALASKAYes

What is NPI?

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This page was last updated on: 11/21/2025

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