SOUTHCENTRAL FOUNDATION NPI 1699393132

NPI Information

  • NPI: 1699393132
  • Provider Name: SOUTHCENTRAL FOUNDATION
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Doing Business As: DENTAL- ANMC OR CLINIC
  • Address: 4315 DIPLOMACY DR
    ANCHORAGE, AK
    ZIP 99508
  • Phone: (907) 729-2000

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NPI Details

SOUTHCENTRAL FOUNDATION is an oral and maxillofacial surgery dentist in Anchorage, AK. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SOUTHCENTRAL FOUNDATION NPI is 1699393132. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dental- Anmc Or Clinic.

The provider's business location address is:

4315 DIPLOMACY DR
ANCHORAGE, AK
ZIP 99508-926
Phone: (907) 729-2000

The provider's authorized official is Ronald Lee Olson .
The authorized official title is Executive Vice President Finance and has the following contact phone number (907) 729-4939.

The enumeration date for this NPI number is 7/10/2020 and was last updated on 9/14/2023.

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
11223P0221XDentistPediatric DentistryNo
21223S0112XDentistOral and Maxillofacial SurgeryYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11616111MEDICAIDALASKA

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: 11/21/2025

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