{"npi":"1124603733","type":"NPI-2","status":"active","name":{"display":"Southcentral Foundation","other":[],"organization_name":"SOUTHCENTRAL FOUNDATION","authorised_official":"Ronald Olson"},"specialty":{"primary_taxonomy":"1223G0001X","primary_taxonomy_description":"General Practice Dentistry","slug":"general-practice-dentistry","schema_org_specialty":null,"all":[{"code":"261QM1300X","description":"Multi-Specialty Clinic/Center","primary":false,"state":null,"license":null},{"code":"261QM2500X","description":"Medical Specialty Clinic/Center","primary":false,"state":null,"license":null},{"code":"1223G0001X","description":"General Practice Dentistry","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1001 S KNIK GOOSE BAY RD","city":"WASILLA","state":"AK","postal_code":"996548083","country_code":"US","phone":"9076317690"},{"purpose":"MAILING","street_1":"PO BOX 35151","city":"SEATTLE","state":"WA","postal_code":"981245151","country_code":"US"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1584443","state":"AK","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2021-03-15","last_updated":"2026-06-05","_meta":{"source":"NPPES","snapshot_date":"2026-06-05","doc_url":"https://findmynpi.com/api"}}