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DENTAL- NILAVENA DENTAL CLINIC ( EAGLESOFT & DOLPH
NPI 1396292298
Dentist - General Practice in Iliamna, AK

Active since September 08, 2016
101 AIRPORT ROAD, ILIAMNA, AK 99606(907) 571-1818 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dental- Nilavena Dental Clinic ( Eaglesoft & Dolph NPPES

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

DENTAL- NILAVENA DENTAL CLINIC ( EAGLESOFT & DOLPH (NPI 1396292298) is a healthcare organization registered as a general practice in Iliamna, 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

NPI1396292298
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHCENTRAL FOUNDATION
Location Address101 AIRPORT ROADIliamna, AK 99606
Mailing AddressPo Box 35151Seattle, WA 98124-5151
Phone(907) 571-1818
Organization SubpartYes
Authorized OfficialRonald Lee OlsonExecutive Vice President Finance · (907) 729-4939
Enumeration DateSeptember 8, 2016
Last NPPES UpdateSeptember 5, 2023
NPPES CertifiedSeptember 1, 2023
✔ NPI 1396292298 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.
101 AIRPORT ROAD, Iliamna, AK 99606
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Other Names 1

Doing Business AsDental- Nilavena Dental Clinic ( Eaglesoft & Dolph

Other Identifiers 1

Medicaid1654555AK

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 5

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

JACQUELINE A JENSEN
Counselor
101 AIRPORT ROAD
ILIAMNA, AK 99606
Lake And Peninsula Borough (907) 571-1818
SOUTHCENTRAL FOUNDATION
Clinic/Center (Dental)
101 AIRPORT ROAD
ILIAMNA, AK 99606
Lake And Peninsula Borough (907) 571-1818
SOUTHCENTRAL FOUNDATION
Clinic/Center (Multi-Specialty)
101 AIRPORT ROAD
ILIAMNA, AK 99606
Lake And Peninsula Borough (907) 571-1818
ANNE ELIZABETH DAILEY PA
Physician Assistant
101 AIRPORT ROAD
ILIAMNA, AK 99606
Lake And Peninsula Borough (907) 729-8624
SUZANNE MARGARET MILETTE PA-C
Physician Assistant
101 AIRPORT ROAD
ILIAMNA, AK 99606
Lake And Peninsula Borough (907) 729-8624

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 1396292298. It was assigned to this organization in the NPPES registry on September 8, 2016. The provider is doing business as Dental- Nilavena Dental Clinic ( Eaglesoft & Dolph.

Where is Southcentral Foundation located?

Southcentral Foundation is located at 101 Airport Road, Iliamna, AK 99606. The listed phone number is (907) 571-1818.

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 5, 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.