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RIVER DISTRICT MODERN DENTISTRY PLLC
NPI 1215685599
Clinic/Center - Dental in Liberty Lake, WA

Active since March 15, 2022
21808 E INDIANA AVE, LIBERTY LAKE, WA 99019(509) 408-5080(509) 461-0403 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About River District Modern Dentistry Pllc NPPES

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

RIVER DISTRICT MODERN DENTISTRY PLLC (NPI 1215685599) is a healthcare organization registered as a dental in Liberty Lake, Washington and active in the NPI registry since March 2022. The organization lists Mark Bradle, Owner, as its authorized official.

NPPES Registry Identity

NPI1215685599
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameRIVER DISTRICT MODERN DENTISTRY PLLC
Location Address21808 E INDIANA AVELiberty Lake, WA 99019-4004
Mailing Address21808 E Indiana AveLiberty Lake, WA 99019-4004 · (509) 408-5080 · Fax (509) 461-0403
Phone(509) 408-5080
Fax(509) 461-0403
Organization SubpartNo
Authorized OfficialMark BradleOwner · (509) 408-5080
Enumeration DateMarch 15, 2022
Last NPPES UpdateMarch 7, 2023
NPPES CertifiedMarch 7, 2023
✔ NPI 1215685599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
21808 E INDIANA AVE, Liberty Lake, WA 99019
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AVANTA DENTAL LIBERTY LAKE
Dentist (General Practice)
21808 E INDIANA AVE
LIBERTY LAKE, WA 99019
Spokane County (509) 425-0088

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 River District Modern Dentistry PLLC's NPI number?

The NPI number for River District Modern Dentistry PLLC is 1215685599. It was assigned to this organization in the NPPES registry on March 15, 2022.

Where is River District Modern Dentistry PLLC located?

River District Modern Dentistry PLLC is located at 21808 E Indiana Ave, Liberty Lake, WA 99019. The listed phone number is (509) 408-5080.

What is River District Modern Dentistry 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 River District Modern Dentistry PLLC was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.