ENDODONTICS OF SOUTHEASTERN WA, PLLC (NPI# 1437313616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437313616 |
| Entity Type | Organization |
| Organization Name | ENDODONTICS OF SOUTHEASTERN WA, PLLC |
| Other Organization Name | ADVANCED ENDODONTIC CARE, LLC |
| Practice Address |
10505 W Clearwater Ave Bldg. A Kennewick WA 99336-8613 |
| Practice Telephone | 5097359735 |
| Practice Fax Number | 5097359598 |
| Mailing Telephone | 5097359735 |
| Mailing Fax Number | 5097359598 |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2008-07-16 |
| Authorized Official Name | DR. LINDA K BASCOM (OWNER) |
| Authorized Official Telephone | 5097359735 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
8842 | WA | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
10481 | WA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
7350 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ROLF M.W. WUERCH, DDS | 1386692556 | 01 | |
| JAMES E. LEONARD, DDS | 1164582722 | 01 | |
| LINDA K. BASCOM, DDS | 1245390996 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Endodontic Care, LLC | Doing Business As Name - Organization |
| Street Address |
10505 W CLEARWATER AVE BLDG. A |
| City | KENNEWICK |
| State | WA |
| Zip Code | 99336-8613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225226343 | Stephen W Hansen | Dentist | 10505 W Clearwater Ave, Bldg A, Kennewick, WA 99336-8613 | 2007-10-15 |
| 1720615446 | Ashley Mccutchen | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2020-03-24 |
| 1164060166 | Gregroy Thomas Lofgren Jr. | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2019-12-20 |
| 1023652716 | Deanna Larson | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2019-11-05 |
| 1003450792 | Omar Sanchez | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2019-11-05 |
| 1992348072 | Erin Breann Morgan | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2019-10-22 |
| 1316598642 | Diana Crane | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2019-09-27 |
| 1447737648 | Natasha Morrison | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2018-07-20 |
| 1851755839 | Three Rivers Therapy, LLC | Counselor | 10505 W Clearwater Ave, Kennewick, WA 99336 | 2016-04-06 |
| 1801265053 | Debra Lynn Pugh | Nurse Practitioner | 10505 W Clearwater Ave, Kennewick, WA 99336-8613 | 2015-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497393888 | Kelsie D Parvinen | Massage Therapist | 8350 W. Grandridge Blvd, Suite 100, Kennewick, WA 99336 | 2019-12-16 |
| 1508403858 | New U Women's Clinic & Aesthetics Pllc | Nurse Practitioner | 35 S Louisiana St, Suite A120, Kennewick, WA 99336 | 2019-12-05 |
| 1457901944 | Solar Mobility LLC | Durable Medical Equipment & Medical Supplies | 949 S Keller St, Kennewick, WA 99336 | 2019-09-17 |
| 1023662590 | Shane Arthur Gulley | Counselor | 500 N. Morain St Suite 1250, Kennewick, WA 99336 | 2019-08-01 |
| 1063973873 | Farah Saleem | Student in an Organized Health Care Education/Training Program | 212 W. 10th Avenue,suite 202, Kennewick, WA 99336 | 2019-03-26 |
| 1255897690 | Thomas Stanley Mcgowan | Student in an Organized Health Care Education/Training Program | Tri-cities Cancer Center, 7350 W. Deschutes Ave, Building A, Kennewick, WA 99336 | 2019-02-11 |
| 1770068280 | Remedy Urgent Mobile Medicine Pllc | Nurse Practitioner | 3311 West Clearwater Avenue, Suite D210, Kennewick, WA 99336 | 2018-10-01 |
| 1740767011 | Zachary Wilber Fournier | Specialist/Technologist | Toyota Center - 7000 West Grandridge Blvd, Kennewick, WA 99336 | 2018-07-19 |
| 1649780693 | Alan Arnold Hanson | Chiropractor | 8350 W. Grandridge Blvd #100, Kennewick, WA 99336 | 2017-10-04 |
| 1922528827 | Sarah Nicole Childress | Counselor | 415 North Morain St, Kennewick, WA 99336 | 2017-06-21 |
| Find all providers in zip 99336 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942591243 | Bradley P Brown | Dentist | 7409 W Grandridge Blvd., Kennewick, WA 99336-6710 | 2011-04-21 |
| 1245390996 | Linda Kathryn Bascom | Dentist | 10505 W. Clearwater Ave., Building A, Kennewick, WA 99338 | 2006-12-11 |
| 1316268998 | Garth Hatch, Dds & Chad Dawson, Dds Pllc | Dentist | 7409 W Grandridge Blvd, Kennewick, WA 99336-6710 | 2010-06-17 |
| 1841336153 | Bradley P Brown Dds Ps | Dentist | 7409 W Grandridge Blvd, Kennewick, WA 99336 | 2007-01-30 |
| 1164582722 | James E Leonard | Dentist | 10505 W. Clearwater Ave., Building A, Kennewick, WA 99338 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801403936 | Olsson & Niazi Pllc | Dentist | 3212 Nw Byron St Ste 108, Silverdale, WA 98383-9154 | 2020-09-23 |
| 1003432709 | Ralph Donald Hawkins | Dentist | 14921 182nd Ave E, Bonney Lake, WA 98391-8240 | 2020-06-18 |
| 1326695438 | M Shoaib Haider Siddiqui | Dentist | Issaquah Modern Dentistry, 1416 Highlands Drie Ne, Suite 120, Issaquah, WA 98029 | 2019-08-22 |
| 1558854844 | Hintz, Olaru, & Penberthy, Dds, Pllc | Dentist | 823 W 7th Ave Ste 202, Spokane, WA 99204-2850 | 2018-06-11 |
| 1316447758 | 3d Endodontics | Dentist | 451 Duvall Ave Ne Ste 120, Renton, WA 98059-4675 | 2018-02-12 |
| 1780101113 | Elena Andronova | Dentist | 1200 116th Ave Ne Ste G1, Bellevue, WA 98004-3802 | 2017-08-25 |
| 1679099246 | Randy L Ball Pllc | Dentist | 336 228th Ave Ne Ste 201, Sammamish, WA 98074-7290 | 2017-08-16 |
| 1104348739 | Roshanak Baghai, Pllc | Dentist | 1340 8th St Ne Ste 102, Auburn, WA 98002-4700 | 2017-07-14 |
| 1699219709 | Tanaya Kumar | Dentist | 4901 Point Fosdick Dr. Nw Street 300, Gig Harbor, WA 98335 | 2016-12-08 |
| 1871042002 | Richard Simcock Dds, Ps | Dentist | 130 S 15th St Suite 101, Mount Vernon, WA 98274 | 2016-09-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.