Scott Soderstrom D D S P C

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SCOTT SODERSTROM D D S P C

Practice address

101 W Cascade Way Ste 200
Spokane, WA 99208-6000

Phone

(509) 467-5202

Fax

(509) 466-0518

NPI assigned

Jul 20, 2017

Organization subpart

No

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

Authorized official

Name

Tracy Johnson

Title

Patient Accounts and Billing

Phone

(509) 467-5202

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1316460421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W CASCADE WAY STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086000",
            "telephone_number": "509-467-5202",
            "fax_number": "509-466-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W CASCADE WAY STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086000",
            "telephone_number": "509-467-5202",
            "fax_number": "509-466-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT SODERSTROM D D S P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PATIENT ACCOUNTS AND BILLING",
        "authorized_official_telephone_number": "509-467-5202"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5034749",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay Heyden Sciuchetti, DDS
• James Scollard
• Scott Chiropractic Center Inc
• Scott J. Starley DDS, MSD, PS
• Scott M Lindquist DC PLLC
• Alexander Scott, MD
• Amanda Scott
• Amaryllis J. Scott, M.D.
• Ashlee Louise Scott
• Ashley E Scott, PHARMD

• Dental Clinic/Center in Spokane, WA
• Providers in Spokane, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.