Provider Demographics
NPI:1861291056
Name:RICHARD V SODERGREN DDS PS
Entity type:Organization
Organization Name:RICHARD V SODERGREN DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SODERGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-277-5000
Mailing Address - Street 1:2000 BENSON RD S STE 260
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4452
Mailing Address - Country:US
Mailing Address - Phone:425-277-5000
Mailing Address - Fax:
Practice Address - Street 1:2000 BENSON RD S STE 260
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4452
Practice Address - Country:US
Practice Address - Phone:425-277-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental