OrganizationActive
River District Modern Dentistry PLLC
NPI 1215685599 · Dental Clinic/Center · Liberty Lake, WA
Provider details
- NPI number
- 1215685599
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Bradle, Owner(509) 408-5080
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(60/100 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
21808 E Indiana Ave
Liberty Lake, WA 99019-4004
Phone: (509) 408-5080
Fax: (509) 461-0403
Approximate (ZIP-level) locationGet directions
Mailing address
21808 E Indiana Ave
Liberty Lake, WA 99019-4004
Registry dates
- Enumerated
- 2022-03-15
- Last updated
- 2023-03-07
- Certified
- 2023-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.