ODESSA DENTAL CLINIC
NPI 1831683168
Dentist in Odessa, WA

NPI Status: Active since June 20, 2018

Contact Information

20 W 1ST AVE
ODESSA, WA
ZIP 99159
Phone: (209) 982-2605

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  • Organization
  • Dentist
  • Accepts Insurance

About ODESSA DENTAL CLINIC

This page provides the complete NPI Profile along with additional information for Odessa Dental Clinic, a provider established in Odessa, Washington operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1831683168 assigned on June 2018. The practitioner's primary taxonomy code is 122300000X with license number DE00010090 (WA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Odessa Dental Clinic. The authorized official of this NPI record is Mrs. Nina Stewart (Administrative Assistant)

NPI
1831683168
Provider Legal Name
GREGG LIEDTKA DMD PLLC
Other Organization Name
ODESSA DENTAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
20 W 1ST AVE ODESSA, WA 99159
Location Phone
(209) 982-2605
Mailing Address
PO BOX 429 ODESSA, WA 99159
Mailing Phone
(509) 982-2605
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-20-2018
Last Update Date
07-03-2018
Code Navigator

A dentist like Odessa Dental Clinic is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist

Taxonomy Code
122300000X
Type
Dental Providers
License No.
DE00010090
License State
WA
Taxonomy Description
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1122300000XDental Providers

Dentist

DE00008440 (WA)

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Premera Blue Cross Alaska One Gold - PPO
  • Premera Blue Cross Preferred Bronze 5800 HSA - PPO
  • Premera Blue Cross Preferred Bronze 6350 - PPO
  • Premera Blue Cross Preferred Gold 1500 - PPO
  • Premera Blue Cross Preferred Silver 4500 - PPO
  • Premera Blue Cross Standard Bronze II - PPO
  • Premera Blue Cross Standard Gold - PPO
  • Premera Blue Cross Standard Silver - PPO
  • Premera Blue Cross Family Dental - PPO
  • Premera Blue Cross Pediatric Dental - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. NINA STEWART

Authorized Official Title
ADMINISTRATIVE ASSISTANT
Authorized Official Phone
(520) 431-4313

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
604262185OTHER (01)WASTATE OF WASHINGTON UBI

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1831683168, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
3
Doubled → 6
Pos 4
1
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
8
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 6 → 12 → 3 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 6 + 1 + 1 + 2 + 8 + 6 + 1 + 1 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1831683168.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831683168, enumerated as an "organization" on June 20, 2018.

The provider is located at 20 W 1ST AVE ODESSA, WA 99159 and the phone number is (209) 982-2605.

Dentist with taxonomy code 122300000X.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska, Medicare. Please consult your insurance carrier or call the provider to verify.