Organization Active NPI

Nicholas Raklios, DDS, PLLC

Doing business as Timberline Oral Surgery & Dental Implants

  • Oral and Maxillofacial Surgery (Dentist)
  • Spokane, WA
National Provider Identifier
1225922123
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
NICHOLAS RAKLIOS, DDS, PLLC
Doing business as
Timberline Oral Surgery & Dental Implants
Practice address
2807 S Stone St Ste 202
Spokane, WA 99223-4904
Phone
(623) 267-8121
NPI assigned
Jun 5, 2025
Organization subpart
Yes
Parent organization
NICHOLAS RAKLIOS, DDS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Cassandra Wieth
Title
Director of Payor Relations
Phone
(623) 267-8121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

2807 S Stone St Ste 202
Spokane, WA 99223-4904

Mailing address

2807 S Stone St Ste 202
Spokane, WA 99223-4904
Phone (623) 267-8121

Other names 1

  • Timberline Oral Surgery & Dental Implants Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nicholas Raklios DDS PLLC5 organizations share this tax ID, including this one
Part of
Nicholas Raklios DDS PLLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2807 S Stone St
Ste 202
Spokane, WA 99223
Phone (509) 209-9300

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1225922123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 S STONE ST STE 202",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234904",
            "telephone_number": "623-267-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 S STONE ST STE 202",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234904",
            "telephone_number": "623-267-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS RAKLIOS, DDS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NICHOLAS RAKLIOS, DDS, PLLC",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "WIETH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "623-267-8121"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timberline Oral Surgery & Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.