Southcentral Foundation

General Practice Dentistry · Wasilla, AK

Organization Active NPI

NPI number 1124603733

Practice location

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone
(907) 631-7690

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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

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X — —
Multi-Specialty Clinic/Center 261QM1300X — —
Medical Specialty Clinic/Center 261QM2500X — —

Mailing address

PO Box 35151
Seattle, 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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