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DENTAL- PEDRO BAY DENTAL CLINIC
NPI 1144777046
Dentist - General Practice in Pedro Bay, AK

Active since September 08, 2016
2516 MOUNTAIN CIRCLE, PEDRO BAY, AK 99647(907) 850-2229 Get Directions Write a Review

NPPES record last updated: September 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dental- Pedro Bay Dental Clinic NPPES

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

DENTAL- PEDRO BAY DENTAL CLINIC (NPI 1144777046) is a healthcare organization registered as a general practice in Pedro Bay, 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

NPI1144777046
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHCENTRAL FOUNDATION
Location Address2516 MOUNTAIN CIRCLEPedro Bay, AK 99647
Mailing AddressPo Box 35151Seattle, WA 98124-5151
Phone(907) 850-2229
Organization SubpartYes
Authorized OfficialRonald Lee OlsonExecutive Vice President Finance · (907) 729-4939
Enumeration DateSeptember 8, 2016
Last NPPES UpdateSeptember 1, 2023
NPPES CertifiedAugust 31, 2023
✔ NPI 1144777046 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.
2516 MOUNTAIN CIRCLE, Pedro Bay, AK 99647
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Other Names 1

Doing Business AsDental- Pedro Bay Dental Clinic

Other Identifiers 1

Medicaid1654571AK

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 3

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

CHELSEA STARR MALSTROM
Community Health Worker
2516 MOUNTAIN CIRCLE
PEDRO BAY, AK 99647
Lake And Peninsula Borough (907) 850-2229
SOUTHCENTRAL FOUNDATION
Community/Behavioral Health
2516 MOUNTAIN CIRCLE
PEDRO BAY, AK 99647
Lake And Peninsula Borough (907) 850-2229
SOUTHCENTRAL FOUNDATION
Clinic/Center (Community Health)
2516 MOUNTAIN CIRCLE
PEDRO BAY, AK 99647
Lake And Peninsula Borough (907) 850-2229

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 1144777046. It was assigned to this organization in the NPPES registry on September 8, 2016. The provider is doing business as Dental- Pedro Bay Dental Clinic.

Where is Southcentral Foundation located?

Southcentral Foundation is located at 2516 Mountain Circle, Pedro Bay, AK 99647. The listed phone number is (907) 850-2229.

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 September 1, 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.