Southcentral Foundation
General Practice Dentistry · Wasilla, AK
Practice location
1001 S Knik Goose Bay RdWasilla, AK 99654-8083
- Phone
- (907) 631-7690
NPI record
- NPI
- 1124603733
- Entity type
- Organization (Type 2)
- Enumeration date
- March 15, 2021
- Last updated
- June 5, 2026
- Certified
- June 5, 2026
- Organization subpart
- Yes
- Parent organization
- Southcentral Foundation
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Dentistry Primary | 1223G0001X |
— | — |
| Multi-Specialty Clinic/Center | 261QM1300X |
— | — |
| Medical Specialty Clinic/Center | 261QM2500X |
— | — |
Mailing address
PO Box 35151Seattle, WA 98124-5151
Authorized official
- Name
- Ronald Lee Olson
- Title
- Executive Vice President Finance
- Phone
- (907) 729-4939
Other names
- Benteh Nuutah Dental Clinic
- Dental- Valley Dental Clinic
About Southcentral Foundation
Southcentral Foundation is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083. The NPI number 1124603733 was assigned on March 15, 2021 and the record was last updated on June 5, 2026.
The authorized official for this organization is Ronald Lee Olson, Executive Vice President Finance.
Frequently asked questions
What is the NPI number of Southcentral Foundation?
The NPI number is 1124603733.
What is the phone number of Southcentral Foundation?
The phone number listed for the practice location is (907) 631-7690.
Where is Southcentral Foundation located?
1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083.
What is the taxonomy code for Southcentral Foundation?
The primary taxonomy code is 1223G0001X – General Practice Dentistry; 2 more listed above.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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