Organization · Type 2 NPI

Southcentral Foundation

Dental Clinic/Center · Anchorage, AK

NPI number 1467124560 Active

Practice location

4115 Ambassador Dr Ste H210
Anchorage, AK 99508-5928

Call (907) 729-2000 Map

Mailing address

PO Box 35151
Seattle, WA 98124-5151

Specialties and licenses

Taxonomy	Code	License
Dentist	122300000X	None listed
Dental Clinic/Center Primary	261QD0000X	None listed
Multi-Specialty Clinic/Center	261QM1300X	None listed
Medical Specialty Clinic/Center	261QM2500X	None listed

Dental Clinic/Center: Definition to come...

Other dental clinic/center providers in Anchorage

See all in Anchorage →

NPI record

NPI: 1467124560
Entity type: Organization (Type 2)
Issued: Sep 28, 2021
Last updated: Apr 1, 2026
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
Dental- Ambassador Drive Dental Clinic · doing business as

Authorized official

Ronald Lee Olson
Executive Vice President Finance
(907) 729-4939

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1467124560

Southcentral Foundation's National Provider Identifier is 1467124560, issued on Sep 28, 2021. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Anchorage, AK. The record was last updated on Apr 1, 2026.