OrganizationActive
Southcentral Foundation
NPI 1124603733 · General Practice Dentistry · Wasilla, AK
Provider details
- NPI number
- 1124603733
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Parent organization
- Southcentral Foundation
- Organization subpart
- Yes
- Authorized official
- Ronald Olson, Executive Vice President Finance(907) 729-4939
Specialties & taxonomies
Dental Providers
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
- Medical Specialty Clinic/Center261QM2500X
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone: (907) 631-7690
Street-level locationGet directions
Mailing address
Po Box 35151
Seattle, WA 98124-5151
Other names (DBA / former)
- Doing business as
- Benteh Nuutah Dental Clinic
- Doing business as
- Dental- Valley Dental Clinic
Registry dates
- Enumerated
- 2021-03-15
- Last updated
- 2026-06-05
- Certified
- 2026-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.