OrganizationActive
Shadle Smile Source PLLC
NPI 1154083822 · Dental Clinic/Center · Spokane, WA
Provider details
- NPI number
- 1154083822
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Timothy Casey, President(509) 280-0002
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4610 N Ash St Ste 2o1
Spokane, WA 99205-1482
Phone: (509) 325-4313
Street-level locationGet directions
Mailing address
2513 N Chase Ln
Liberty Lake, WA 99019-7533
Registry dates
- Enumerated
- 2021-10-11
- Last updated
- 2021-10-11
- Certified
- 2021-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.