SOUTHCENTRAL FOUNDATION DENTAL DHAT (NPI# 1962726364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962726364 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION DENTAL DHAT |
| Practice Address |
4341 Tudor Centre Dr Anchorage AK 99508-5904 |
| Mailing Address |
Po Box 196320 Anchorage AK 99519-6320 |
| Practice Telephone | 9073176070 |
| Practice Fax Number | 8067941919 |
| Mailing Telephone | 9073176070 |
| Mailing Fax Number | 8067941919 |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2010-03-15 |
| Authorized Official Name | KATHRYN S MILLER (PATIENT ACCOUNTS MANAGER- DENTAL) |
| Authorized Official Telephone | 9073176070 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHCENTRAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
AK | Ambulatory Health Care Facilities |
| Street Address |
4341 TUDOR CENTRE DR |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851341416 | Kerry Jae Ozer | Psychiatry & Neurology | 4341 Tudor Centre Dr, Third Floor, Anchorage, AK 99508-5904 | 2006-05-12 |
| 1548826332 | Kayla Knight | Case Manager/Care Coordinator | 4341 Tudor Centre Dr, Anchorage, AK 99508-5904 | 2019-05-16 |
| 1730745696 | Erik Eckberg | Counselor | 4341 Tudor Centre Dr, Anchorage, AK 99508-5904 | 2019-05-16 |
| 1588138275 | Dustin William Allen | Counselor | 4341 Tudor Centre Dr, Anchorage, AK 99508 | 2019-01-15 |
| 1740788223 | Southcentral Foundation | Community Health Worker | 4341 Tudor Centre Dr, Anchorage, AK 99508-5904 | 2018-01-30 |
| 1306367669 | Ekaterina Vladimir Kalachevskiy | Counselor | 4341 Tudor Centre Dr, Anchorage, AK 99508-5904 | 2017-06-27 |
| 1730638933 | Jaslyn F Wren | Dental Therapist | 4341 Tudor Centre Dr, Fireweed Dental Building, Anchorage, AK 99508-5904 | 2016-09-28 |
| 1477945400 | Nathon Allan Blackburn | Dentist | 4341 Tudor Centre Dr, Fireweed Dental, Anchorage, AK 99508-5904 | 2015-02-27 |
| 1902162977 | Janece W Richard | Counselor | 4341 Tudor Centre Dr, 3rd Floor, Anchorage, AK 99508-5904 | 2012-04-04 |
| 1508137217 | Lisa M Alexia | Physician Assistant | 4341 Tudor Centre Dr, Anchorage, AK 99508-5904 | 2012-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011593 | Deyoung Dentistry, LLC | Clinic/Center | 2601 Boniface Parkway Suite 1, Anchorage, AK 99504 | 2020-07-29 |
| 1205461084 | Hawkinson Dental Inc | Clinic/Center | 6200 Lake Otis Pkwy Ste 101, Anchorage, AK 99507-2098 | 2020-03-11 |
| 1932664877 | Alaska Family Dental LLC | Clinic/Center | 405 W 36th Ave Ste 101, Anchorage, AK 99503-5872 | 2019-02-05 |
| 1659862134 | Evelyn Haley Dmd | Clinic/Center | 615 E 82nd Ave Ste 100, Anchorage, AK 99518-3100 | 2018-05-21 |
| 1154672558 | Mabry and Mabry Dentistry, LLC | Clinic/Center | 2601 Boniface Pkwy Ste 1, Anchorage, AK 99504-3144 | 2012-09-25 |
| 1912179094 | Warren Urda Dds | Clinic/Center | 237 E Fireweed Ln Ste 101, Anchorage, AK 99503-2000 | 2008-03-28 |
| 1649348723 | Huffman Family Dentistry LLC | Clinic/Center | 12350 Industry Way #210, Anchorage, AK 99515 | 2006-11-30 |
| 1568540946 | Pete B. Higgins Dds LLC | Clinic/Center | 3901 Raspberry Rd, Anchorage, AK 99502-1973 | 2006-11-01 |
| 1003415696 | Ryan, LLC | Clinic/Center | 1310 E Dimond Blvd Ste 3, Anchorage, AK 99515-2031 | 2020-10-23 |
| 1972150365 | Anchorage Camai Dental Clinic, LLC | Clinic/Center | 4361 Boniface Pkwy, Anchorage, AK 99504-4314 | 2019-08-21 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.