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Contact Information

SOUTH ANCHORAGE DENTAL CENTER
9170 JEWEL LAKE RD STE 201
ANCHORAGE, AK99502-5390
 Phone: 907-248-7275
 Fax: 907-248-7221
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for SOUTH ANCHORAGE DENTAL CENTER

NPI # 1841580966
LBN Legal business name SOUTH ANCHORAGE DENTAL CENTER
Authorized official BROC BRIMHALL - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/11/2011
Last updated 04/11/2011 - About 15 years ago
Identifiers
AK License # 1308
AK Medicaid DD0040
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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