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LIFEHOUSE DENTAL CLINIC
NPI 1043767940
Dentist - General Practice in Sutton, AK

Active since September 08, 2016
11495 N. CALLISON STREET, SUTTON, AK 99674(907) 631-7665 Get Directions Write a Review

NPPES record last updated: August 31, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lifehouse Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFEHOUSE DENTAL CLINIC (NPI 1043767940) is a healthcare organization registered as a general practice in Sutton, Alaska and active in the NPI registry since September 2016. The organization lists Ronald Lee Olson, Executive Vice President Finance, as its authorized official.

NPPES Registry Identity

NPI1043767940
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHCENTRAL FOUNDATION
Location Address11495 N. CALLISON STREETSutton, AK 99674
Mailing AddressPo Box 35151Seattle, WA 98124-5151
Phone(907) 631-7665
Organization SubpartYes
Authorized OfficialRonald Lee OlsonExecutive Vice President Finance · (907) 729-4939
Enumeration DateSeptember 8, 2016
Last NPPES UpdateAugust 31, 2023
NPPES CertifiedAugust 31, 2023
✔ NPI 1043767940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in AK · 20467
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.
11495 N. CALLISON STREET, Sutton, AK 99674
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Other Names 2

Doing Business AsLifehouse Dental Clinic
Doing Business AsDental- Lifehouse Dental Clinic

Other Identifiers 1

Medicaid1654481AK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHCENTRAL FOUNDATION
Community/Behavioral Health
11495 N. CALLISON STREET
SUTTON, AK 99674
Matanuska-Susitna Borough (907) 631-7665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southcentral Foundation's NPI number?

The NPI number for Southcentral Foundation is 1043767940. It was assigned to this organization in the NPPES registry on September 8, 2016. The provider is doing business as Lifehouse Dental Clinic and Dental- Lifehouse Dental Clinic.

Where is Southcentral Foundation located?

Southcentral Foundation is located at 11495 N. Callison Street, Sutton, AK 99674. The listed phone number is (907) 631-7665.

What is Southcentral Foundation's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Southcentral Foundation was last updated on August 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.