DR. SCOTT SODERSTROM D D S P C NPI 1457326878

NPI Information

NPI: 1457326878
Provider Name: DR. SCOTT SODERSTROM, D D S P C
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
101 W CASCADE WAY
SUITE 200
SPOKANE, WA
ZIP 99208
Phone: (509) 467-5202
Get Directions

DR. Scott Soderstrom, D D S P C is a general practice dentist in Spokane, WA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Scott Soderstrom, D D S P C NPI is 1457326878. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 W CASCADE WAY
SUITE 200
SPOKANE, WA
ZIP 99208-003
Phone: (509) 467-5202
Fax: (509) 466-0518

The NPI 1457326878 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 2/20/2006 and was last updated on 1/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	DE00008668	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5037479	MEDICAID	WASHINGTON
2	DE00008668	OTHER	WASHINGTON	STATE DENTAL LICENSE
3	21933	OTHER	WASHINGTON	UNITED CONCORDIA ID
4	602-040-560	OTHER	WASHINGTON	UNIFIED BUSINESS ID
5	1287SO	OTHER		BLUE CROSS
6	0150532	OTHER	WASHINGTON	LABOR AND INDUSTRIES ID#
7	174980063	OTHER		ADA NUMBER
8	91-2051287	OTHER		TAX ID #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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