DENTAL- PORT ALSWORTH CLINIC
NPI 1114480167
Clinic/Center - Dental in Port Alsworth, AK

Q: What is Southcentral Foundation's NPI number?

The NPI number for Southcentral Foundation is 1114480167. It was assigned to this organization in the NPPES registry on April 8, 2019. The provider is doing business as Dental- Port Alsworth Clinic.

Q: What is Southcentral Foundation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since April 08, 2019

1 FLIGHT LINE RD, PORT ALSWORTH, AK 99653(907) 781-2256 Get Directions Write a Review

NPPES record last updated: August 31, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 31, 2023, Apr 8, 2019 (2 updates tracked since 2019).

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About Dental- Port Alsworth Clinic NPPES

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

DENTAL- PORT ALSWORTH CLINIC (NPI 1114480167) is a healthcare organization registered as a dental in Port Alsworth, Alaska and active in the NPI registry since April 2019. The organization lists Ronald Lee Olson, Executive Vice President Finance, as its authorized official.

NPPES Registry Identity

NPI1114480167

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameSOUTHCENTRAL FOUNDATION

Location Address1 FLIGHT LINE RDPort Alsworth, AK 99653-9801

Mailing AddressPo Box 35151Seattle, WA 98124-5151

Phone(907) 781-2256

Organization SubpartYes

Authorized OfficialRonald Lee OlsonExecutive Vice President Finance · (907) 729-4939

Enumeration DateApril 8, 2019

Last NPPES UpdateAugust 31, 20232 updates tracked since enumeration

NPPES CertifiedAugust 31, 2023

✔ NPI 1114480167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

1 FLIGHT LINE RD, Port Alsworth, AK 99653

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Other Names 1

Doing Business AsDental- Port Alsworth Clinic

Other Identifiers 1

Medicaid1695503AK

Other Providers at the Same Location NPPES 3

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

LISA KAY STIMPSON FNP

Nurse Practitioner (Family)

1 FLIGHT LINE RD
PORT ALSWORTH, AK 99653

Lake And Peninsula Borough (907) 781-2256

SOUTHCENTRAL FOUNDATION

Clinic/Center (Community Health)

1 FLIGHT LINE RD
PORT ALSWORTH, AK 99653

Lake And Peninsula Borough (907) 781-2256

SOUTHCENTRAL FOUNDATION

Community/Behavioral Health

1 FLIGHT LINE RD
PORT ALSWORTH, AK 99653

Lake And Peninsula Borough (907) 781-2256

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 1114480167. It was assigned to this organization in the NPPES registry on April 8, 2019. The provider is doing business as Dental- Port Alsworth Clinic.

Where is Southcentral Foundation located?

Southcentral Foundation is located at 1 Flight Line Rd, Port Alsworth, AK 99653. The listed phone number is (907) 781-2256.

What is Southcentral Foundation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

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.