SOUTH ANCHORAGE DENTAL CENTER
NPI 1841580966
Preferred Provider Organization in Anchorage, AK

Active since April 11, 2011
9170 JEWEL LAKE RD STE 201, ANCHORAGE, AK 99502(907) 248-7275(907) 248-7221 Get Directions Write a Review

NPPES record last updated: April 11, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About South Anchorage Dental Center NPPES

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

SOUTH ANCHORAGE DENTAL CENTER (NPI 1841580966) is a healthcare organization registered as a preferred provider organization in Anchorage, Alaska and active in the NPI registry since April 2011. The organization lists Broc Wayne Brimhall, Dentist, as its authorized official.

NPPES Registry Identity

NPI1841580966
Entity TypeOrganization
Primary Taxonomy305R00000X
Legal Business NameSOUTH ANCHORAGE DENTAL CENTER
Location Address9170 JEWEL LAKE RD STE 201Anchorage, AK 99502-5390
Mailing Address9170 Jewel Lake Rd Ste 201Anchorage, AK 99502-5390 · (907) 248-7275 · Fax (907) 248-7221
Fax(907) 248-7221
Organization SubpartNo
Authorized OfficialBroc Wayne BrimhallDentist · (907) 248-7275
Enumeration DateApril 11, 2011
NPI 1841580966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPreferred Provider OrganizationManaged Care Organizations
Taxonomy Code305R00000X
License Licensed in AK · 1308
Definition

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

9170 JEWEL LAKE RD STE 201, Anchorage, AK 99502

Other Identifiers 1

MedicaidDD0040AK

Accepted Insurance

Other Providers at the Same Location NPPES

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

Dentist (General Practice)
9170 JEWEL LAKE RD STE 201
ANCHORAGE, AK 99502

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1841580966, enumerated as an "organization" on April 11, 2011.

The provider is located at 9170 JEWEL LAKE RD STE 201 ANCHORAGE, AK 99502 and the phone number is (907) 248-7275.

Preferred Provider Organization with taxonomy code 305R00000X.

The provider might be accepting Accepts: Delta Dental of Alaska, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.