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SHADLE SMILE SOURCE PLLC
NPI 1154083822
Clinic/Center - Dental in Spokane, WA

Active since October 11, 2021
4610 N ASH ST STE 2O1, SPOKANE, WA 99205(509) 325-4313 Get Directions Write a Review

NPPES record last updated: October 11, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shadle Smile Source Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADLE SMILE SOURCE PLLC (NPI 1154083822) is a healthcare organization registered as a dental in Spokane, Washington and active in the NPI registry since October 2021. The organization lists Timothy Casey, President, as its authorized official.

NPPES Registry Identity

NPI1154083822
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameSHADLE SMILE SOURCE PLLC
Location Address4610 N ASH ST STE 2O1Spokane, WA 99205-1482
Mailing Address2513 N Chase LnLiberty Lake, WA 99019-7533
Phone(509) 325-4313
Organization SubpartNo
Authorized OfficialTimothy CaseyPresident · (509) 280-0002
Enumeration DateOctober 11, 2021
NPPES CertifiedOctober 11, 2021
✔ NPI 1154083822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
4610 N ASH ST STE 2O1, Spokane, WA 99205
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shadle Smile Source PLLC's NPI number?

The NPI number for Shadle Smile Source PLLC is 1154083822. It was assigned to this organization in the NPPES registry on October 11, 2021.

Where is Shadle Smile Source PLLC located?

Shadle Smile Source PLLC is located at 4610 N Ash St Ste 2o1, Spokane, WA 99205. The listed phone number is (509) 325-4313.

What is Shadle Smile Source PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Shadle Smile Source PLLC was last updated on October 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.