NPIMap

Organization Active NPI

Endodontics of Southeastern Wa, PLLC

  • Endodontics
  • Kennewick, WA
National Provider Identifier
1437313616
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7350 Issued in WA
Legal business name
ENDODONTICS OF SOUTHEASTERN WA, PLLC
Practice address
10505 W Clearwater Ave
BLDG. a
Kennewick, WA 99336-8613
Phone
(509) 735-9735
Fax
(509) 735-9598
NPI assigned
Jul 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Dr. Linda K Bascom, DDSNPI 1245390996
Title
Owner
Phone
(509) 735-9735

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 7350 WA Primary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 8842 WA
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 10481 WA

Addresses

Primary practice location

10505 W Clearwater Ave
BLDG. a
Kennewick, WA 99336-8613

Mailing address

10505 W Clearwater Ave
BLDG. a
Kennewick, WA 99336-8613
Phone (509) 735-9735

Other identifiers 3

IdentifierTypeStateIssuer
1164582722OtherJAMES E. LEONARD, DDS
1245390996OtherLINDA K. BASCOM, DDS
1386692556OtherROLF M.W. WUERCH, DDS

Other names 1

  • Advanced Endodontic Care, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

10505 W Clearwater Ave
Bldg A
Kennewick, WA 99336
Phone (509) 378-5553

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1437313616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 W CLEARWATER AVE",
            "address_2": "BLDG. A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368613",
            "telephone_number": "509-735-9735",
            "fax_number": "509-735-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10505 W CLEARWATER AVE",
            "address_2": "BLDG. A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368613",
            "telephone_number": "509-735-9735",
            "fax_number": "509-735-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTICS OF SOUTHEASTERN WA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "BASCOM",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-735-9735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "7350",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "8842",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "10481",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAMES E. LEONARD, DDS",
            "identifier": "1164582722",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LINDA K. BASCOM, DDS",
            "identifier": "1245390996",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROLF M.W. WUERCH, DDS",
            "identifier": "1386692556",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Endodontic Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.