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DENTAL- INDIAN CREEK DENTAL CLINIC
NPI 1659828556
Dentist - General Practice in Tyonek, AK

Active since September 08, 2016
101 INDIAN CREEK ROAD, TYONEK, AK 99682(907) 583-2461 Get Directions Write a Review

NPPES record last updated: September 14, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dental- Indian Creek Dental Clinic NPPES

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

DENTAL- INDIAN CREEK DENTAL CLINIC (NPI 1659828556) is a healthcare organization registered as a general practice in Tyonek, 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

NPI1659828556
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHCENTRAL FOUNDATION
Location Address101 INDIAN CREEK ROADTyonek, AK 99682
Mailing AddressPo Box 35151Seattle, WA 98124-5151
Phone(907) 583-2461
Organization SubpartYes
Authorized OfficialRonald Lee OlsonExecutive Vice President Finance · (907) 729-4939
Enumeration DateSeptember 8, 2016
Last NPPES UpdateSeptember 14, 2023
NPPES CertifiedSeptember 14, 2023
✔ NPI 1659828556 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 INDIAN CREEK ROAD, Tyonek, AK 99682
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Other Names 1

Doing Business AsDental- Indian Creek Dental Clinic

Other Identifiers 1

Medicaid1654559AK

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.

KIMBERLY SHAYD ULERY CHA III
Community Health Worker
101 INDIAN CREEK ROAD, BOX 82068
TYONEK, AK 99682
Kenai Peninsula Borough (907) 729-6752
SOUTHCENTRAL FOUNDATION
Clinic/Center (Mental Health (Including Community Mental Health Center))
101 INDIAN CREEK ROAD
TYONEK, AK 99682
Kenai Peninsula Borough (907) 583-2461
SOUTHCENTRAL FOUNDATION
Clinic/Center (Community Health)
101 INDIAN CREEK ROAD
TYONEK, AK 99682
Kenai Peninsula Borough (907) 583-2461

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 1659828556. It was assigned to this organization in the NPPES registry on September 8, 2016. The provider is doing business as Dental- Indian Creek Dental Clinic.

Where is Southcentral Foundation located?

Southcentral Foundation is located at 101 Indian Creek Road, Tyonek, AK 99682. The listed phone number is (907) 583-2461.

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 14, 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.