SOUTHCENTRAL FOUNDATION


Address: 6901 E Tudor Rd, Anchorage, AK 99507-1254
Phone: 9073176070

SOUTHCENTRAL FOUNDATION (NPI# 1972050870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972050870
Entity Type Organization
Organization Name SOUTHCENTRAL FOUNDATION
Other Organization Name CHUGACH SQUARE DENTAL CLINIC
Practice Address 6901 E Tudor Rd
Anchorage
AK 99507-1254
Mailing Address Po Box 35151
Seattle
WA 98124-5151
Practice Telephone 9073176070
Practice Fax Number 9077295178
Mailing Telephone 9073176070
Mailing Fax Number 9077295178
Enumeration Date 2016-09-08
Last Update Date 2016-09-08
Authorized Official Name KEVIN GOTTLIEB (VICE PRESIDENT)
Authorized Official Telephone 9073176070
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
20467 AK Dental Providers

Other Provider/Organization Names

Other Name Type Code
Chugach Square Dental Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1407466204 Southcentral Foundation Clinic/Center 11495 N Callison St, Sutton, AK 99674 2020-08-06
1528600947 Southcentral Foundation Clinic/Center 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 2019-10-17
1639722069 Southcentral Foundation Community/Behavioral Health 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 2019-07-24
1659924025 Southcentral Foundation Community/Behavioral Health 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 2019-07-24
1720548035 Southcentral Foundation Clinic/Center 4441 Diplomacy Dr Fl 5, Anchorage, AK 99508-5910 2019-03-22
1750854089 Southcentral Foundation Clinic/Center 400 W Benson Blvd, Anchorage, AK 99503-3829 2019-01-09
1639652662 Southcentral Foundation Clinic/Center 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 2018-09-14
1811420391 Southcentral Foundation Clinic/Center 1021 E 3rd Ave, Anchorage, AK 99501-6102 2017-04-11
1043767940 Southcentral Foundation Dentist 11495 N. Callison Street, Sutton, AK 99674 2016-09-08
1689021776 Southcentral Foundation Clinic/Center 755 A St, Anchorage, AK 99501-3625 2016-05-18

Office Location

Street Address 6901 E TUDOR RD
City ANCHORAGE
State AK
Zip Code 99507-1254

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578571022 Richard Gregorin Dentist 6901 E Tudor Rd, Suite 9, Anchorage, AK 99507-1241 2006-08-03
1982804068 Southcentral Foundation Clinic/Center 6901 E Tudor Rd, Anchorage, AK 99507-1241 2007-07-18
1588873384 Richard Charles Gregorin II Dentist 6901 E Tudor Rd, Suite #9, Anchorage, AK 99507-1241 2007-05-21
1871702688 R C Gregorin II Dds LLC Clinic/Center 6901 E Tudor Rd, Suite #9, Anchorage, AK 99507-1241 2007-05-21
1942414933 Southcentral Foundation Case Management 6901 E Tudor Rd, Suite 8, Anchorage, AK 99507-1241 2007-05-09
1851440978 Southcentral Foundation Clinic/Center 6901 E Tudor Rd, Anchorage, AK 99507-1241 2007-01-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124634233 Mackena Elsie Johnson Massage Therapist Sports & Spinal Injury Clinic, 6634 Lake Otis Pkwy #a, Anchorage, AK 99507 2020-09-23
1710599808 Abracadabra Speech LLC Speech-Language Pathologist 6823 Tudor Road, Anchorage, AK 99507 2020-08-19
1487111241 Fe Comon Nursing Home Administrator 1841 E 57th Ave., 1841 E 57th Ave., Anchorage, AK 99507 2019-02-27
1780171249 Carol Won Pharmacist 2550 E. 88th Ave., Anchorage, AK 99507 2018-04-19
1821549411 Isioma Nwaeme Registered Nurse 2529 Rives Court, Anchorage, AK 99507 2016-10-18
1669921268 Michaelyn Scott Massage Therapist 1601 E. Dimond Blvd., Suite 201, Anchorage, AK 99507 2016-09-25
1013387638 Robert R Croley Case Manager/Care Coordinator 1515 E Tudor Rd Ste 6, Anchorage, AK 99507 2015-09-25
1124494265 Ryan Scott Fordt Chiropractor 2665 E Tudor Rd Ste 201, Anchorage, AK 99507 2015-08-12
1073907465 Sarah E Lawrence Case Manager/Care Coordinator 1750 Abbott Road, Alzheimer's Resource of Alaska, Anchorage, AK 99507 2015-03-24
1699184507 Melissa Lingad Nurse's Aide 7691 Winchester St., Anchorage, AK 99507 2014-08-05
Find all providers in zip 99507

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568024388 North Coast Dental LLC Dentist 2020 Abbott Rd Ste 1, Anchorage, AK 99507-4624 2019-07-01
1215433768 Ryan P. Ersland, D.m.d. LLC Dentist 2525 Gambell St Ste 304a, Anchorage, AK 99503-2838 2018-04-03
1699289645 Jae Won Lee Dentist 726 E. 9th Avenue, Anchorage, AK 99501 2017-11-29
1295271492 Maurice J Welch Dds A Professional Corporation Dentist 4450 Cordova St Ste 210, Anchorage, AK 99503-7273 2017-01-11
1811355456 Geon Bae Dentist 3340 Providence Dr Ste 552, Anchorage, AK 99508 2016-02-09
1326421850 Hyrum Murdoch Dentist 4200 Lake Otis Pkwy Ste 201, Anchorage, AK 99508-5226 2015-07-01
1043603194 Keith D. Mcgranahan Dentist 1407 W 31st St., Anchorage, AK 99503 2015-03-13
1376941260 Joshua Michael Kennedy Dentist 625 E 34th Ave Ste 301, Anchorage, AK 99503-4154 2014-12-09
1649609439 Smiles Dental Alaska, LLC Dentist 9138 Arlon St Ste B, Anchorage, AK 99507-3876 2013-11-02
1790027134 Healthy Smiles Forever, LLC Dentist 5576 Sapphire Loop, Anchorage, AK 99504-6000 2013-03-25
Find all providers in ANCHORAGE

Competitor

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City ANCHORAGE
Zip Code 99507

Improve Information

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Dataset Information

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.

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