Karen L Soderquist, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18115 Issued in MI

Practice address

3085 W Russell Rd
Tecumseh, MI 49286

Phone

(517) 423-2135

Fax

(517) 423-0009

NPI assigned

Apr 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 42 North Dental Care of Michigan, PLLC

  dba Great Lakes Family Dental, Tecumseh

  • Dental Clinic/Center
  • Tecumseh, MI
  • NPI 1033859939
  NPD (past)
• Great Lakes Family Dental Group - Tecumseh PC

  • General Practice Dentistry
  • Tecumseh, MI
  • NPI 1447342589
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417070111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 W RUSSELL RD",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "49286",
            "telephone_number": "517-423-2135",
            "fax_number": "517-423-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 W RUSSELL RD",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "49286",
            "telephone_number": "517-423-2135",
            "fax_number": "517-423-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERQUIST",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric P Smith, DO
• Elizabeth Jane Snelling
• Alan Herbert Snider, D.O.
• Michael John Snyder-Barker, LMSW CAAC
• Sarah Sobus
• Melanie Ann St Bernard, PHD
• Joshua Ronald Staffeld, PHARMD
• Rhea Staniszewski, LCSW
• Makayla Christine Stasa, M.A. SLP-CF
• Stephen Bartee DPM

• General Practice Dentistry in Tecumseh, MI
• Providers in Tecumseh, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.