South Anchorage Dental Center

LBN: South Anchorage Dental Center
South Anchorage Dental Center is an health care organization with primary practice located at 9170 Jewel Lake Rd Ste 201 , Anchorage AK 99502-5390. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. South Anchorage Dental Center can be contacted via phone (907) 248-7275, or through Brimhall, Broc Wayne via phone (907) 248-7275.

Contact Information

Primary practice address
9170 Jewel Lake Rd Ste 201 Anchorage AK 99502-5390
Phone: (907) 248-7275
Fax: (907) 248-7221
Website:
Map and Directions
Authorized official contact:
Name: Brimhall, Broc Wayne Doctor of Dental Medicine (DMD)
Phone: (907) 248-7275

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X 1308 Alaska

Profile Details

NPI number 1841580966
LBN Legal business name South Anchorage Dental Center
DBA Doing business as
Authorized official Brimhall, Broc Wayne Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2011
Last updated Apr 11th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841580966 NPPES
Alaska MEDICAID DD0040

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