Dan Soderberg OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002472 Issued in PA

Legal business name

DAN SODERBERG OD LLC

Practice address

808 W Main St
Grove City, PA 16127-1114

Phone

(724) 458-8533

Fax

(724) 458-0911

NPI assigned

Oct 17, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daniel Thomas Soderberg, O.D.

Title

Optometrist

Phone

(724) 458-8533

Specialties & licenses 1

Addresses

Other names 1

• Grove City Optical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1225313661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W MAIN ST",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271114",
            "telephone_number": "724-458-8533",
            "fax_number": "724-458-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W MAIN ST",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271114",
            "telephone_number": "724-458-8533",
            "fax_number": "724-458-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN SODERBERG OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "SODERBERG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "724-458-8533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grove City Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Community Counseling Center of Mercer County
• Connect Hearing, Inc.
• Karen Ann Costa
• John Clyde Court, DC
• Samuel Mark Courtney
• David L. Rothman, MD, PC
• Nathan Davis, LPC
• Delta Foot and Ankle Center, LLC
• Mark A Demidovich, M.D.
• Denise Garver, Ma, NCC, LPC

• Optometrist in Grove City, PA
• Providers in Grove City, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.