ANDREW J SODERHOLM DDS
NPI 1336379528
Dentist - Oral and Maxillofacial Surgery in Alexandria, MN

Q: What is Andrew Soderholm's NPI number?

The NPI number for Andrew Soderholm is 1336379528. It was assigned to this individual provider in the NPPES registry on July 22, 2009.

Q: What is Andrew Soderholm's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Andrew Soderholm enrolled in Medicare?

No. Andrew Soderholm has opted out of Medicare through May 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Andrew Soderholm was last updated on October 24, 2022. 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.

Active since July 22, 2009Opted out of Medicare · through May 16, 2027

120 12TH AVENUE EAST, ALEXANDRIA, MN 56308(320) 298-1000 Get Directions Write a Review

NPPES record last updated: October 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 24, 2022, Oct 17, 2022 (2 updates tracked since 2022).

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About Andrew J Soderholm Dds NPPES

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

ANDREW J SODERHOLM DDS (NPI 1336379528) is an individual oral and maxillofacial surgery provider in Alexandria, Minnesota, licensed in Minnesota (D13189) and active in the NPI registry since July 2009. He has opted out of Medicare through May 16, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1336379528

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameANDREW J SODERHOLMCredential: DDS

Location Address120 12TH AVENUE EASTAlexandria, MN 56308

Mailing Address120 12th Avenue EastAlexandria, MN 56308 · (320) 298-1000

Phone(320) 298-1000

Sole ProprietorYes

Enumeration DateJuly 22, 2009

Last NPPES UpdateOctober 24, 20222 updates tracked since enumeration

NPPES CertifiedOctober 24, 2022

✔ NPI 1336379528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in MN · D13189

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

120 12TH AVENUE EAST, Alexandria, MN 56308

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Andrew J Soderholm Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 16, 2013 through May 16, 2027.

Opt-Out Effective DateMay 16, 2013

Opt-Out In Effect ThroughMay 16, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56308 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Andrew Soderholm's NPI number?

The NPI number for Andrew Soderholm is 1336379528. It was assigned to this individual provider in the NPPES registry on July 22, 2009.

Where is Andrew Soderholm located?

Andrew Soderholm practices at 120 12th Avenue East, Alexandria, MN 56308. The listed phone number is (320) 298-1000.

What is Andrew Soderholm's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Andrew Soderholm enrolled in Medicare?

No. Andrew Soderholm has opted out of Medicare through May 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Andrew Soderholm was last updated on October 24, 2022. 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.