Kumudra Tin Soe, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE60972753 Issued in WA

Practice address

7533 Olympic View Dr Ste C
Edmonds, WA 98026-5524

Phone

(425) 670-2392

Fax

(425) 776-8173

NPI assigned

Jul 22, 2019

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 WA

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

Practice roles

Locations

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

• Kumudra T Soe DMD PLLC

  • Dental Clinic/Center
  • Edmonds, WA
  • NPI 1417713199
  NPD
• Familia Dental Janesville LLC

  • Dental Clinic/Center
  • Janesville, WI
  • NPI 1437508405
  NPD (past)

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1497308159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7623 222ND ST SW UNIT B",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267966",
            "telephone_number": "626-551-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7533 OLYMPIC VIEW DR STE C",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980265524",
            "telephone_number": "425-670-2392",
            "fax_number": "425-776-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOE",
        "first_name": "KUMUDRA",
        "middle_name": "TIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60972753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Smith, DPT
• Smyle Denture Design
• Cheryl Ann Snyder, MSW
• Denise Evelyn So, DC
• Matthew So, DC
• Dosoon Soh, MNP
• Alsia Marie Soiset
• Victor Frank Solley, OTR
• Anca Francisca Soloschi, RDN
• Solutions Engineering and Design

• Dentist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.