Soderholm Oral Surgery and Implants

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SODERHOLM ORAL SURGERY AND IMPLANTS

Doing business as

Soderholm Oral Surgery and Implants

Practice address

120 12TH Ave E
Alexandria, MN 56308-2528

Phone

(320) 298-1000

Fax

(320) 227-3423

NPI assigned

Mar 13, 2023

Organization subpart

No

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

Authorized official

Name

Andrew Soderholm, DDSNPI 1336379528

Title

Owner/Doctor

Phone

(320) 298-1000

Specialties & licenses 1

Addresses

Other names 1

• Soderholm Oral Surgery and Implants Doing business as

Locations

Practitioners 1

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

• Andrew J Soderholm, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Alexandria, MN
  • NPI 1336379528
  NPD Authorized official

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1841991262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 12TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082528",
            "telephone_number": "320-298-1000",
            "fax_number": "320-227-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 12TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082528",
            "telephone_number": "320-298-1000",
            "fax_number": "320-227-3423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Market St",
            "address_purpose": "LOCATION",
            "city": "Perham",
            "state": "MN",
            "postal_code": "565732118",
            "country_code": "US",
            "telephone_number": "320-298-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 N Tower Rd",
            "address_purpose": "LOCATION",
            "city": "Fergus Falls",
            "state": "MN",
            "postal_code": "565371016",
            "country_code": "US",
            "telephone_number": "320-298-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SODERHOLM ORAL SURGERY AND IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "SODERHOLM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "320-298-1000",
        "authorized_official_credential": "DDS"
    },
    "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": "Soderholm Oral Surgery and Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason M Slivnik, MS, ATC
• Laura Sloan, OTR/L
• Heidi Smith, MA, ATC
• Rachel Anne Smith
• Samuel Smith
• Andrew J Soderholm, DDS
• Carrie Jo Soine, PTA
• Joseph Solberg, ATC
• Victoria Soltis
• Steven James Solum, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.