Dental- Fireweed Dental Clinic

LBN: Southcentral Foundation
Dental- Fireweed Dental Clinic is an health care organization with primary practice located at 4341 Tudor Centre Dr , Anchorage AK 99508-5904. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Prosthodontics. Dental Providers / General Practice is the primary health care specialty. Southcentral Foundation can be contacted via phone (907) 729-2000, or through Olson, Ronald Lee via phone (907) 729-4939.

Contact Information

Primary practice address
4341 Tudor Centre Dr Anchorage AK 99508-5904
Phone: (907) 729-2000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Olson, Ronald Lee
Phone: (907) 729-4939

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X
Dental Providers / Prosthodontics 1223P0700X

Profile Details

NPI number 1316527575
LBN Legal business name Southcentral Foundation
DBA Doing business as Dental- Fireweed Dental Clinic
Authorized official Olson, Ronald Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 12th, 2021
Last updated Sep 1st, 2023 - about 3 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 1316527575 NPPES
Alaska MEDICAID 1003875

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